Kiely David, Lewis Carianne, Gray Juliet, Hall Nigel
Department of Paediatric Surgery and Urology, Queens Medical Centre, Nottingham, UK.
Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
Pediatr Blood Cancer. 2021 Nov;68(11):e29237. doi: 10.1002/pbc.29237. Epub 2021 Jul 31.
There is increasing recognition that contralateral metachronous tumor may occur following treatment of unilateral mature ovarian teratoma. We aimed to define this risk to guide appropriate surveillance strategies. We undertook a systematic review of three large medical databases (Ovid Medline, Embase, and Cochrane Controlled Trials Register) to April 2020 using a defined search strategy. From 1831 articles retrieved, 23 were included, reporting 1101 girls with unilateral mature ovarian teratomas. The intensity and duration of follow-up varied between studies, with only five reporting close surveillance. Overall prevalence of metachronous contralateral mature teratoma was 2.1%, with a prevalence per study of 0%-23% (median 0%). Prevalence was higher (7%) among studies with more robust surveillance. These data suggest a small but real risk of metachronous contralateral tumors. Surveillance ultrasonography is proportionate and indicated alongside further prospective data collection to record the natural history and impact of surveillance in greater detail.
越来越多的人认识到，单侧成熟卵巢畸胎瘤治疗后可能会发生对侧异时性肿瘤。我们旨在明确这种风险，以指导适当的监测策略。我们使用既定的检索策略，对截至2020年4月的三个大型医学数据库（Ovid Medline、Embase和Cochrane对照试验注册库）进行了系统评价。从检索到的1831篇文章中，纳入了23篇，报道了1101例患有单侧成熟卵巢畸胎瘤的女孩。各研究之间随访的强度和持续时间各不相同，只有5项研究报告了密切监测。异时性对侧成熟畸胎瘤的总体患病率为2.1%，每项研究的患病率为0%-23%（中位数为0%）。在监测更完善的研究中，患病率更高（7%）。这些数据表明，异时性对侧肿瘤存在虽小但实际的风险。监测超声检查是合理的，同时还需要进一步进行前瞻性数据收集，以更详细地记录自然病史和监测的影响。
