Department of Pathology, Hangzhou Women's Hospital, Hangzhou, China,
Department of Pathology, Hangzhou Women's Hospital, Hangzhou, China.
Oncol Res Treat. 2021;44(4):145-153. doi: 10.1159/000509189. Epub 2021 Mar 11.
The aim of this study was to investigate the clinicopathological prognostic factors of malignant ovarian germ cell tumors (MOGCT) and evaluate the survival trends of MOGCT by histotype.
We extracted data on 1,963 MOGCT cases diagnosed between 2000 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) database and the histological classification of MOGCT, including 5 categories: dysgerminoma, embryonal carcinoma (EC), yolk sac tumor, malignant teratoma, and mixed germ cell tumor. We examined overall and disease-specific survival of the 5 histological types. Kaplan-Meier and Cox proportional hazards regression models were used to estimate survival curves and prognostic factors. We also estimated survival curves of MOGCT according to different treatments.
There was a significant difference in prognosis among different histological classifications. Age, histotype, grade, SEER stage, and surgery were independent prognostic factors for survival of patients with MOGCT. For all histotypes, 1-, 3-, and 5-year survival rate estimates were >85%, except for EC, which had the worst outcomes at 1 year (55.6%), 3 years (44.4%), and 5 years (33.3%). In the distant SEER stage, both chemotherapy and surgery were associated with improved survival outcomes compared with surgery- and chemotherapy-only groups.
Dysgerminoma patients had the most favorable outcomes, whereas EC patients had the worst survival. A young age, low grade, and surgery were all significant predictors for improved survival. In contrast, a distant SEER stage was a risk factor for poor survival. Chemotherapy combined with surgery contributed to longer survival times of patients with MOGCT in the distant SEER stage.
本研究旨在探讨恶性卵巢生殖细胞肿瘤（MOGCT）的临床病理预后因素，并按组织类型评估 MOGCT 的生存趋势。
我们从监测、流行病学和最终结果（SEER）数据库中提取了 2000 年至 2014 年间诊断的 1963 例 MOGCT 病例数据，并对 MOGCT 的组织学分类进行了分析，包括 5 类：无性细胞瘤、胚胎癌（EC）、卵黄囊瘤、恶性畸胎瘤和混合生殖细胞肿瘤。我们检查了 5 种组织类型的总生存率和疾病特异性生存率。Kaplan-Meier 和 Cox 比例风险回归模型用于估计生存曲线和预后因素。我们还根据不同的治疗方法估计了 MOGCT 的生存曲线。
不同组织学分类之间的预后存在显著差异。年龄、组织类型、分级、SEER 分期和手术是影响 MOGCT 患者生存的独立预后因素。对于所有组织类型，1、3 和 5 年生存率估计值均>85%，除 EC 外，其 1 年（55.6%）、3 年（44.4%）和 5 年（33.3%）生存率最差。在远处 SEER 分期中，与单独手术或化疗组相比，化疗和手术均与改善的生存结局相关。
无性细胞瘤患者的结局最好，而 EC 患者的生存最差。年轻、低级别和手术均是生存改善的显著预测因素。相反，远处 SEER 分期是生存不良的危险因素。化疗联合手术有助于改善远处 SEER 分期 MOGCT 患者的生存时间。
