Fertility-Sparing Surgery Should Be the Standard Treatment in Patients with Malignant Ovarian Germ Cell Tumors

Türkmen, Osman; Karalök, Alper; Başaran, Derman; Kimyon, Gunsu; Taşçı, Tolga; Üreyen, Işın; Tulunay, Gökhan; Turan, Taner

doi:10.1089/jayao.2016.0086

Cited by 30 publications

(33 citation statements)

References 21 publications

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“…MOGCTs are rare tumors, which mainly affects patients in reproductive age [13]. The increase of therapeutic rates has moved the attention of recent studies on variations of the menstrual cycle and…”

Section: Discussionmentioning

confidence: 99%

“…Although in subjects with ovarian dysfunction at the starting stage, the association of the GnRH analogue may be indicated. Pre-treatment anti-Mullerian-hormone (AMH) serum levels and age of each patient, appear to be reliable predictive factors of ovarian activity recovery after treatment [13,36].…”

Section: Methodsmentioning

confidence: 99%

“…A variable long-term survival rate of 82%-100% is reported in the literature in the early stages and 75% in the advanced stages [12].Considering the frequent incidence of MOGCTs in young women and the high survival rate clinician should consider fertility-sparing surgery (FSS) [13]. The correct information about the risks of iatrogenic infertility and the strategies available to reduce the incidence of this effect (reproductive counselling) should be offered to young cancer patients immediately after diagnosis, subsequent stage of the disease and before the start of treatment [14].…”

Section: Introductionmentioning

confidence: 99%

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Germinal Ovarian Tumors In Reproductive Age Women: Fertility-Sparing And Outcome

Dellino

Silvestris

Loizzi

et al. 2020

Preprint

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Purpose MOGCTs (malignant ovarian germ cell tumours) is a rare tumour, which mainly affects patients in reproductive age. The aim of this study is evaluate the fertility and survival outcomes in young women with MOCGTs treated with fertility-sparing surgery (FFS).Methods From 2000 to 2018 twenty-eight patients with diagnosis of MOGCTs in reproductive age at the University of Bari were collected. Most received FFS and in patients treated conservatively, the reproductive outcome and survival were investigated. Data of patient demographics, clinical presentation, oncology markers 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 patientsResults Twenty-eight patients with diagnosis of MOGCTs were collected. The median age was 24 (range: 9-45). The majority of the patients had stage IIIC. Twenty-four woman received fertility-sparing surgery consisting in 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 FFS in MOGCTs can produce good results both on reproductive outcomes and on survival. Indeed, in our group there was only one case of exitus as result of recurrence. On the other side, patients after FFS maintained normal ovarian function and 5/5 women who have looked for pregnancy, obtained it spontaneously. The median follow-up was 90 moth (range 3-159).Conclusion Conservative surgery for MOGCTs should be considered for women in the reproductive age group who desire preservation of fertility.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Germinal Ovarian Tumors In Reproductive Age Women: Fertility-Sparing And Outcome

Dellino

Silvestris

Loizzi

et al. 2020

Preprint

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“…We found a difference in the 5-year overall survival between the optimal and sub-optimal cytoreduction groups (p=0.032) (figure 1). Other studies have concluded that there is no relation between management (ie, conservative vs non-conservative) and prognosis of disease 3. However, owing to the rarity of these tumors, prognostic factors are somewhat controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Although they can be diagnosed at any age, dysgerminomas are most commonly found in younger women 2. In patients under age 20, germ-cell tumors represent up to 60% of ovarian masses, and of these a third are malignant 3. Malignant ovarian germ-cell tumors may be classified as dysgerminomas, and non-dysgerminomas, with approximately 30% being dysgerminomas 4…”

Section: Introductionmentioning

confidence: 99%

Role of optimal cytoreduction in patients with dysgerminoma

Bandala-Jacques¹,

Estrada-Rivera²,

Cantú

et al. 2019

Int J Gynecol Cancer

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BackgroundDysgerminomas are malignant ovarian germ-cell tumors that typically affect young women. Although these tumors have an excellent response to chemotherapy, surgery is an integral part of primary treatment.ObjectiveTo evaluate outcomes of initial cytoreduction in patients diagnosed with dysgerminomas.MethodsPatients who underwent primary cytoreductive surgery for ovarian dysgerminoma between January 1985 and December 2013 were identified and included in the study. A comparison was made between patients who underwent optimal versus sub-optimal cytoreduction. Descriptive, comparative statistics and odds ratios were used to establish an association. Survival curves were performed with the Kaplan-Meier method and compared using a log-rank test. A value of p<0.05 was used to establish a statistical difference.ResultsA total of 180 patients with a histologically confirmed dysgerminoma were included in the analysis. A subsection of 37 patients in stages III/IV were analyzed. The median age at diagnosis was 21 years (IQR 18–26). Histologically, 166 (92.2%) patients had pure dysgerminomas, whereas the rest had mixed histologies. The median tumor size was 18 (IQR 12–22) cm. In all stages, factors associated with optimal cytoreduction, were higher lactate dehydrogenase levels (OR=1.01; p=0.03), higher CA125 levels (OR=1.01; p=0.04), receiving adjuvant chemotherapy (OR=0.22; p<0.01), or undergoing treatment in a specialized institution (OR=12.68; p<0.01). Patients in stages III/IV, initially managed outside our institution were less likely to be taken for cytoreduction (OR=16.88; p=0.013). Other factors, including age (OR=1.02; p=0.39), pelvic lymph-node positivity (OR=2.24; p=0.36), pregnancy during follow-up (OR=0.91: p=0.80), or recurrence of disease (OR=1.93; p=0.23) were found to be similar in both groups. Overall survival was higher in optimally cytoreducted patients (100% vs 95.7%; p=0.032) including all stages, but not if considering only stages III/IV (100% vs 90%, p=0.186); disease-free survival was the same for both groups regardless of stage (94.3% vs 91.1%; p=0.36).ConclusionPatients with optimal surgeries were most likely to be treated in referral centers. Initial residual disease did not significantly alter recurrence, progression, disease-free survival, or overall survival.

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Spontaneous pregnancy after fertility‐sparing surgery and adjuvant chemotherapy for advanced pure dysgerminoma: A case report

Göç,

Kastrati

et al. 2024

Clinical Case Reports

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Key Clinical MessageFertility‐sparing surgery and appropriate adjuvant chemotherapy for advanced malignant ovarian germ cell tumors have excellent survival results and promising reproductive and obstetric outcomes.AbstractThis case report aims to demonstrate the potential feasibility and success of fertility‐sparing surgery (FSS) coupled with adjuvant chemotherapy in treating advanced malignant ovarian germ cell tumor (MOGCT), focusing on pure dysgerminoma, fertility, and achieving spontaneous pregnancy. The patient was a 23‐year‐old female who initially presented with complaints of abdominal distension and a palpable mass and was subsequently diagnosed with advanced MOGCT. The patient provided a complete clinical and radiological response to FSS with complete surgical staging and cisplatin‐based chemotherapy (bleomycin, etoposide, and cisplatin). Despite being diagnosed with advanced MOGCT and treated with FSS and adjuvant chemotherapy, she later experienced spontaneous pregnancy, giving birth to a healthy child. This case study demonstrated the potential for successful fertility preservation and pregnancy in advanced‐stage MOGCT patients treated with personalized treatment approaches. Nevertheless, a broader investigation is needed to understand the relevant complex dynamics and to ascertain whether FSS with adjuvant chemotherapy could be a reliable approach in treating advanced MOGCT.

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Fertility-Sparing Surgery Should Be the Standard Treatment in Patients with Malignant Ovarian Germ Cell Tumors

Cited by 30 publications

References 21 publications

Germinal Ovarian Tumors In Reproductive Age Women: Fertility-Sparing And Outcome

Germinal Ovarian Tumors In Reproductive Age Women: Fertility-Sparing And Outcome

Role of optimal cytoreduction in patients with dysgerminoma

Spontaneous pregnancy after fertility‐sparing surgery and adjuvant chemotherapy for advanced pure dysgerminoma: A case report

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