DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20221288
Published: 2022-04-27

Surgical outcome in germ cell tumor of ovary

Pooja R., Varsha Narendra Patil

Abstract


Background: Ovarian cancer accounts for 225,000 new cases and 140,000 deaths every year. Ovarian germ cell tumors account for 15-20% of all ovarian malignancies and incidence of malignant ovarian germ cell tumors is 2-6%. These tumors typically occur in adolescent girls and young women. Appropriate fertility conserving surgical treatment for patients where fertility needs to be preserved and resection of all visible disease can be successfully performed. For patients with advanced-stage disease, debulking surgery is done.

Methods: Current study is a retrospective study. The present study was conducted in the department of obstetrics and gynecology, Cama and Albess hospital, Mumbai, Maharashtra, India, from a period of May 2019 to December 2021. This study was conducted with 30 patients to evaluate the outcome in operated cases of germ cell tumors of ovary.

Results: Majority of the patients (30%) were in the age group of 31-40 years, 17 (56.7%) patients were unmarried while 13 (43.3%) patients were married. The most common symptom was abdominal mass and pain (86.7%). The most common histologic type was dysgerminoma (46.7%). Out of total 19 patients with FIGO stage I, 13 patients (68.4%) underwent Fertility sparing surgery (FSS) and 6 patients (31.6%) underwent non fertility sparing surgery (non-FSS).

Conclusions: Surgery has an important role in the management of germ cell tumors. Initial careful surgical staging is of great importance for appropriate subsequent therapy. Fertility sparing surgery is feasible in most cases. Malignant ovarian germ cell tumors have excellent prognosis for stage I and for advanced stages.


Keywords


Germ cell tumour, Unilateral salphingo-oophorectomy, Debulking surgery

Full Text:

PDF

References


Agarwal R, Rajanbabu A, Keechilattu P. A retrospective analysis of the pattern of care and survival in patients with malignant ovarian germ cell tumors. South Asian J Cancer. 2019; 8(1):35-40.

Kumar RB, Das V. Treatment outcomes in malignant ovarian germ cell tumors. Int J Reprod Contracept Obstet Gynecol. 2017;6:5256-60.

Lakshmanan M, Gupta S, Kumar V. Germ cell tumor ovary: an institutional experience of treatment and survival outcomes. Indian J Surg Oncol. 2018;9(2): 215-9.

Morice P, Denschlag D, Rodolakis A, Reed N, Schneider A, Kesic V, et al. Recommendations of the fertility task force of the european society of gynecologic oncology about the conservative management of ovarian malignant tumors. Int J Gynecol Cancer. 2011;21:951-63.

Parkinson CA, Hatcher HM, Earl HM, Ajithkumar TV. Multidisciplinary management of malignant ovarian germ cell tumours. Gynecol Oncol. 2011;121:625-36.

Downey J, McKinney M. The psychiatric status of women presenting for infertility evaluation. Am J Orthop. 1992;62:196-8

Zanetta G, Bonazzi C, Cantu M, Binidagger S, Locatelli A, Bratina G, Mangioni C. Survival and reproductive function after treatment of malignant germ cell ovarian tumors. J Clin Oncol. 2017;19(4): 1015-20

Perrin LC, Low J, Nicklin JLWard BG, Crandon AJ. Fertility and ovarian function after conservative surgery for germ cell tumors of the ovary. Aust N Z J Obstet Gynecol. 1999;39(2):243-5.

Ezzat A, Raja M, Bakri Y, Subhi J, Memon M, Schwartz P, Stuart R. Malignant ovarian germ cell tumors: a survival and prognostic analysis. Acta Oncol. 1999;38(4):455-60.

Brewer M, Gerhenson DM, Herzog CE Mitchell MF, Silva EG, Wharton JT. Outcomes and reproductive function after chemotherapy for ovarian dysgerminoma. J Clin Oncol. 1999;17(9):2670-5.

Ovarian Cancer including fallopian tube cancer and Primary peritoneal cancer. Available at: http://www. nccn.org/professionals/physician. Accessed on 20 October 2021.

Bonazzi C, Peccatori F, Colombo N, Lucchini V, Cantù MG, Mangioni C. Pure ovarian immature teratoma, a unique and curable disease: 10 years’ experience of 32 prospectively treated patients. Obstet Gynecol. 1994;84:598-604.

Dark GG, Bower M, Newlands ES, Paradinas F, Rustin GJ. Surveillance policy for stage I ovarian germ cell tumors. J Clin Oncol. 1997;15:620-4.

Cushing B, Giller R, Ablin A, Cohen L, Cullen J, Hawkins E, et al. Surgical resection alone is effective treatment for ovarian immature teratoma in children and adolescents: A report of the pediatric oncologygroup and the children's cancer group. Am J Obstet Gynecol. 1999;181:353-8.

Mitchell PL, Al-Nasiri N, A’Hern R, Fisher C, Horwich A, Pinkerton CR, et al. Treatment of nondysgerminomatous ovarian germ cell tumors: An analysis of 69 cases. Cancer. 1999;85:2232-44.

Patterson DM, Murugaesu N, Holden L, Seckl MJ, Rustin GJ. A review of the close surveillance policy for stage I female germ cell tumors of the ovary and other sites. Int J Gynecol Cancer. 2008;18:43-50.

Mann JR, Raafat F, Robinson K, Imeson J, Gornall P, Phillips M, et al. UKCCSG's germ cell tumour (GCT) studies: Improving outcome for children with malignant extracranial non-gonadal tumourscarbo-platin, etoposide, and bleomycin are effective and less toxic than previous regimens. J Clin Oncol. 2000;18: 3809-18.

Mangili G, Sigismondi C, Gadducci A, Cormio G, Scollo P, Tateo S et al. Outcome and risk factors for recurrence in malignant ovarian germ cell tumors: a MITO-9 retrospective study. Int J Gynecol Cancer. 2011;21(8):1414-21.

Newton C, Murali K, Ahmad A et al. A multicentre retrospective cohort study of ovarian germ cell tumours: Evidence for chemotherapy de-escalation and alignment of paediatric and adult practice. Eur J Cancer. 2019;113(19):e27.