Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2021 Apr;41(2):342-347. doi: 10.1007/s11596-021-2353-y. Epub 2021 Apr 20.
Yolk sac tumors (YSTs) are rare malignant germ cell tumors that usually affect young females. To date, there have been few studies on YSTs. We evaluated the relationship between clinicopathologic characteristics of patients with ovarian YSTs and disease outcome based on Surveillance, Epidemiology, and End Results data. The Kaplan-Meier method and log-rank test were used to evaluate differences in survival rates. Data for 269 patients were analyzed. The incidence of YSTs among ovarian germ cell tumors (OGCTs) cases was 0.4%; median patient age was 22.0 years, and most tumors were unilateral. Patients presented with distant metastasis (37.5%), localized disease (49.1%), and regional spread (8.9%). American Joint Committee on Cancer stage was available for 13 patients (stage IA, n=2; stage IC, n=1; stage IIIA, n=1; stage IIIB, n=3; stage IIIC, n=2; and stage IV, n=4). Survival rates at 1, 3, and 5 years were 91.0%, 84.0%, and 83.2%, respectively, for overall survival (OS) and 92.0%, 85.4%, and 84.5%, respectively, for disease-specific survival (DSS). The 5-year OS and DSS of patients with ovary tumors were 91.5% and 92.9%, respectively, compared to 74.8% and 77.2%, respectively, for those with extra-ovarian spread (P<.001 for both OS and DSS). Age >50 years was associated with shorter OS and DSS (both P<0.001), whereas no associatios of OS and DSS were observed with pathologic grade (P=0.49 for OS and 0.52 for DSS). In summary, YSTs are typically unilateral, of a high grade, and localized to the ovary; extra-ovarian spread has a poor outcome, and postmenopausal women have worse prognosis than premenopausal women.
卵黄囊瘤（YSTs）是一种罕见的恶性生殖细胞肿瘤，通常影响年轻女性。迄今为止，对 YSTs 的研究较少。我们根据监测、流行病学和最终结果数据评估了卵巢 YST 患者的临床病理特征与疾病结局之间的关系。Kaplan-Meier 法和对数秩检验用于评估生存率的差异。分析了 269 例患者的数据。YSTs 在卵巢生殖细胞肿瘤（OGCTs）病例中的发生率为 0.4%；中位患者年龄为 22.0 岁，大多数肿瘤为单侧。患者表现为远处转移（37.5%）、局限性疾病（49.1%）和区域播散（8.9%）。13 例患者的美国癌症联合委员会分期可查（IA 期 2 例，IC 期 1 例，IIIA 期 1 例，IIIB 期 3 例，IIIC 期 2 例，IV 期 4 例）。总生存（OS）的 1、3 和 5 年生存率分别为 91.0%、84.0%和 83.2%，疾病特异性生存（DSS）分别为 92.0%、85.4%和 84.5%。与卵巢肿瘤患者相比，卵巢外播散患者的 5 年 OS 和 DSS 分别为 74.8%和 77.2%（OS 和 DSS 均<0.001）。年龄>50 岁与 OS 和 DSS 较短相关（均<0.001），而 OS 和 DSS 与病理分级无关（OS 为 0.49，DSS 为 0.52）。总之，YSTs 通常为单侧、高级别且局限于卵巢；卵巢外播散预后不良，绝经后女性比绝经前女性预后更差。
