Dellino Miriam, Silvestris Erica, Loizzi Vera, Paradiso Angelo, Loiacono Rosalia, Minoia Carla, Daniele Antonella, Cormio Gennaro
Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Department of Biomedical Sciences and Human Oncology, Unit of Obstetrics and Gynaecology.
Medicine (Baltimore). 2020 Sep 25;99(39):e22146. doi: 10.1097/MD.0000000000022146.
MOGCTs (malignant ovarian germ cell tumors) are rare tumors that mainly affect patients of reproductive age. The aim of this study was to evaluate the fertility and survival outcomes in young women with MOCGTs treated with fertility-sparing surgery (FSS).From 2000 to 2018, data from 28 patients of reproductive age with a diagnosis of MOGCT at the University of Bari were collected. Most received FSS, and in patients treated conservatively, the reproductive outcome and survival were investigated. Data of patient demographics, clinical presentation, oncology marker dosage, staging, type of surgery, histological examination, survival, and reproductive outcome were collected from hospital and office charts. All informed consent was obtained from all patients. The median age was 24 (range: 9-45 years). The majority of the patients had stage IIIC. Twenty-four woman received FSS consisting of unilateral ovariectomy and omentectomy, whereas only 4 women, based on their stage (IIIC), received a radical surgery (hysterectomy with bilateral adnexectomy, lymphadenectomy, and omentectomy). Our study shows that FSS in MOGCTs can produce good results both on reproductive outcomes and on survival. Indeed, in our group, there was only 1 case of exitus as result of recurrence. Furthermore, patients after FSS maintained normal ovarian function and 5 of 5 women who tried to get pregnant succeeded spontaneously. The median follow-up was 90 months (range 3-159).Conservative surgery for MOGCTs should be considered for women of reproductive age who wish to preserve fertility.
恶性卵巢生殖细胞肿瘤(MOGCTs)是一种罕见的肿瘤,主要影响育龄患者。本研究的目的是评估接受保留生育功能手术(FSS)治疗的年轻MOGCTs女性患者的生育能力和生存结果。2000年至2018年,收集了巴里大学28例诊断为MOGCTs的育龄患者的数据。大多数患者接受了FSS,对接受保守治疗的患者的生殖结局和生存情况进行了调查。从医院和办公室病历中收集了患者人口统计学、临床表现、肿瘤标志物剂量、分期、手术类型、组织学检查、生存情况和生殖结局的数据。所有患者均获得了知情同意。中位年龄为24岁(范围:9 - 45岁)。大多数患者为IIIC期。24名女性接受了包括单侧卵巢切除术和大网膜切除术的FSS,而只有4名女性根据其分期(IIIC期)接受了根治性手术(子宫全切术加双侧附件切除术、淋巴结切除术和大网膜切除术)。我们的研究表明,MOGCTs的FSS在生殖结局和生存方面都能产生良好的结果。事实上,在我们的研究组中,只有1例因复发而死亡。此外,接受FSS后的患者卵巢功能保持正常,5名尝试怀孕的女性中有5名自然受孕成功。中位随访时间为90个月(范围3 - 159个月)。对于希望保留生育功能的育龄女性,应考虑对MOGCTs进行保守手术。