Immature teratoma of ovary – outcome following primary and secondary surgery: study of a single institution cohort

Reddihalli, Pallavi V; Subbian, Anbukkani; Umadevi, K; Rathod, Praveen S.; Krishnappa, Shobha; Nanaiah, Shakuntala P.; Bafna, U. D.

doi:10.1016/j.ejogrb.2015.06.017

Cited by 15 publications

(20 citation statements)

References 24 publications

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“…For example, the overall survival rate was 91.6% when all stages were considered, but only 80% for patients with advanced stages of disease. 12 This present study demonstrated a 5-year overall survival rate for our cohort of apparent early-stage patients of 100%. Patients with a higher tumour grade are reported to have a higher rate of recurrence.…”

Section: Discussionsupporting

confidence: 55%

“… 12 These 10 cases support the hypothesis that cystectomy might be a safe option for patients with early-stage immature teratomas. 6 , 11 , 12 …”

Section: Introductionmentioning

confidence: 53%

“…In fact, some researchers have considered that the role of surgical staging in this disease was to avoid adjuvant chemotherapy for low grade early-stage tumours. 12 …”

Section: Discussionmentioning

confidence: 99%

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Ovarian cystectomy in the treatment of apparent early-stage immature teratoma

et al. 2017

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ObjectiveTo investigate the role of ovarian cystectomy in patients with early-stage immature teratoma.MethodsA retrospective review was undertaken on patients diagnosed pathologically with immature teratoma and with malignant lesions confined to the ovary. Patients were included if they had been treated between January 1997 and December 2015 at the Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China. Relevant demographic and clinical data were retrieved from the medical records.ResultsForty-three patients were included in the study; 14 underwent ovarian cystectomy (group 1) and 29 underwent unilateral salpingo-oophorectomy (USO; group 2). Three of the patients who underwent USO relapsed and required a second surgical intervention. The 5-year disease-free survival rates were 100% and 88%for groups 1 and 2, respectively. There were no significant differences between the two groups in terms of survival or postoperative fertility outcomes. Univariate and multivariate analysis further revealed that ovarian cystectomy was not a poor prognostic indicator for disease-free survival.ConclusionThese current data suggest that ovarian cystectomy can be considered for patients with apparent early-stage immature teratoma as it preserves fertility as much as possible without adversely impacting upon survival.

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Section: Discussionsupporting

confidence: 55%

“… 12 These 10 cases support the hypothesis that cystectomy might be a safe option for patients with early-stage immature teratomas. 6 , 11 , 12 …”

Section: Introductionmentioning

confidence: 53%

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Ovarian cystectomy in the treatment of apparent early-stage immature teratoma

et al. 2017

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“…Immature teratoma is often initially managed with incomplete staging surgery because a frozen pathological diagnosis has not yet been made or because a trained gynecologic oncologist is not available 4. However, the rarity of this tumor means that information on the role of staging surgery in pure immature teratoma, especially in adults, is lacking 19. To the best of our knowledge, the current study represents one of the largest studies focusing on the role of complete staging surgery in adult patients with stage I pure immature teratoma.…”

Section: Discussionmentioning

confidence: 99%

Role of staging surgery and adjuvant chemotherapy in adult patients with apparent stage I pure immature ovarian teratoma after fertility-sparing surgery

Wang

Zhu

Jia

et al. 2020

Int J Gynecol Cancer

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ObjectiveThe standard treatment for young patients with stage I malignant ovarian germ cell tumors, except stage I dysgerminoma and stage IA G1 immature teratoma, is unilateral salpingo-oophorectomy with complete staging surgery followed by platinum-based chemotherapy. However, the role of complete staging surgery and adjuvant chemotherapy remains controversial. The aim of this study was to investigate the role of complete staging surgery and adjuvant chemotherapy in patients with early-stage pure immature teratoma after fertility-sparing surgery.MethodsPatients with stage I pure immature teratoma who underwent fertility-sparing surgery between January 1986 and June 2018 were reviewed retrospectively. Fertility-sparing surgery was defined as preservation of the uterus and at least one adnexa. The inclusion criteria were age >18 years, stage I disease (confined to one ovary), and diagnosis of pure immature teratoma. Patients with distant metastasis or mixed ovarian germ cell tumor were excluded. Complete staging surgery was defined as peritoneal cytology examination, peritoneal biopsy, omentectomy, or omental biopsy with or without lymph node dissection. Patients designated with stage I disease without complete staging surgery were categorized as stage X. Disease-free survival was defined as the interval from the date of surgery to the date of recurrence or censoring. Disease-free survival curves were calculated using the Kaplan–Meier method and compared using the log-rank test.ResultsA total of 75 patients were included in the analysis, with a median age of 26 years (range 18–40): 26 (34.7%) patients had received complete staging surgery; 51 (68%) patients received postoperative adjuvant chemotherapy while 24 (32%) underwent surgery alone; and 4 patients (5.3%) had recurrent disease during a median follow-up time of 80.2 months (range 13.7–261). The recurrence rates in the chemotherapy group and surveillance groups were 3.9% and 8.3%, respectively (p=0.46). All patients were successfully salvaged, except for one death. Tumor relapse occurred in patients with all grades of immature teratoma (G1: 1/35; G2: 2/25; G3: 1/15). Univariate analysis revealed that complete staging surgery, adjuvant chemotherapy, and tumor grade were not associated with 5 year disease-free survival (p=0.69, p=0.46, p=0.7, respectively). The 5 year disease-free survival rate was 94.6% and the overall survival rate was 98.7%.ConclusionAdult patients with stage I pure immature teratoma had 98.7% overall survival and recurrence rates were low after fertility-sparing surgery.

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“…Even malignant germ tumors allow conservative management. (27) In menacme, benign adnexal masses are treated by cystectomies, oophorectomies or salpingo-oophorectomies in more than a third of cases. In patients close to menopause, this number is close to 50%.…”

Section: Management Of Adnexal Massmentioning

confidence: 99%