Sağnıç Saliha, Karadağ Ceyda, Tuncer Hasan Aykut, Doğan Selen, Şimşek Tayup
Akdeniz University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Antalya, Turkey.
Turk J Obstet Gynecol. 2023 Jun 1;20(2):97-104. doi: 10.4274/tjod.galenos.2023.98036.
This study aimed to present our single-center clinical experience regarding tumor clinicopathologic features, treatment modalities, and reproductive and oncologic outcomes in patients with non-epithelial ovarian cancer (NEOC) over 25 years.
A total of 100 patients with clinicopathological diagnosis of NEOC who were treated at our tertiary care center between 1996 and 2022 were included in this retrospective cohort analysis study. Data on demographic, clinical and obstetric characteristics of patients at the time of initial diagnosis as well as tumor clinicopathologic features, treatment modalities, and oncological and reproductive outcomes were recorded.
NEOCs involved germ cell tumors (GCTs) in 46 (46%) patients and sex cordstromal tumors (SCSTs) in 54 (54%) patients. Thirty patients with GCTs and thirty-four patients with SCSTs possessed histological subtypes with malignant features. Most patients with GCTs (37%) and SCSTs (55.6%) had FIGO Stage 1 disease at the time of initial diagnosis. Overall, 76.6% of patients in the GCT group (n=23) underwent fertility-sparing surgery (FSS), while 76.5% of the patients in the SCST group (n=26) were treated with non-fertility-sparing surgical procedures. All patients who underwent FSS and had a recurrence in their follow-up (n=4) was stage 3 patients. Seven out of 10 patients (2 patients at stage 3 and 5 patients at stage 1) who desired pregnancy delivered between 38 and 40 gestational weeks without any congenital anomaly. The prognosis was excellent in both groups, with 5-year overall survival (OS) rates of 93.5% in GCTs and 96.3% in SCST groups. The 5-year disease-free survival was 89.1% in GCTs and 94.4% in SCSTs. FSS was not associated with worse oncologic outcomes.
NEOCs usually have a good prognosis because they are detected at an early stage. FSS may be indicated for women of reproductive age with early-stage NEOCs.
本研究旨在介绍我们单中心25年来非上皮性卵巢癌(NEOC)患者的肿瘤临床病理特征、治疗方式以及生殖和肿瘤学结局方面的临床经验。
本回顾性队列分析研究纳入了1996年至2022年期间在我们三级医疗中心接受治疗的100例经临床病理诊断为NEOC的患者。记录了患者初诊时的人口统计学、临床和产科特征数据,以及肿瘤临床病理特征、治疗方式、肿瘤学和生殖结局。
NEOC中,46例(46%)为生殖细胞肿瘤(GCT),54例(54%)为性索间质肿瘤(SCST)。30例GCT患者和34例SCST患者具有恶性特征的组织学亚型。大多数GCT患者(37%)和SCST患者(55.6%)初诊时为FIGO Ⅰ期疾病。总体而言,GCT组76.6%(n = 23)的患者接受了保留生育功能手术(FSS),而SCST组76.5%(n = 26)的患者接受了非保留生育功能的手术治疗。所有接受FSS且随访中复发的患者(n = 4)均为Ⅲ期患者。10例有妊娠意愿的患者中有7例(Ⅲ期2例,Ⅰ期5例)在妊娠38至40周时分娩,且无任何先天性异常。两组预后均良好,GCT组5年总生存率(OS)为93.5%,SCST组为96.3%。GCT组5年无病生存率为89.1%,SCST组为94.4%。FSS与更差的肿瘤学结局无关。
NEOC通常预后良好,因为它们多在早期被发现。对于早期NEOC的育龄女性,可能适合行FSS。