Journal of Shandong University (Health Sciences) ›› 2018, Vol. 56 ›› Issue (5): 35-40.doi: 10.6040/j.issn.1671-7554.0.2018.233

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Preserve fertility in recurrent and uncontrolled malignant ovarian germ cell tumors

WANG Jinhui1, YANG Jiaxin1, YUAN Zhen1, CAO Dongyan1, SHEN Keng1, HUANG Huifang1, WU Ming1, PAN Lingya1, GUO Lina2   

  1. 1. Department of Obstetrics and Gynaecology;
    2. Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science &
    Peking Union Medical College, Beijing 100730, China
  • Received:2018-02-22 Published:2022-09-27

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Abstract: Objective To explore the clinical characteristics, salvage therapy and prognosis of recurrent and uncontrolled malignant ovarian germ cell tumor(MOGCT)and to evaluate the possibility of secondary fertility-sparing surgery. Methods The clinical data of 41 recurrent and uncontrolled MOGCT cases treated during Jan. 1st, 2000 and Mar. 31st, 2017 were retrospectively analyzed. Results There were 18 recurrent and 23 uncontrolled cases. The patients age ranged from 6 to 37 years. FIGO stage: stage I in 25 cases, stage II in 1 case, stage III in 14 cases, and stage IV in 1 case. There were 18 cases of immature teratoma, 14 cases of yolk sac tumor, 1 case of dysgerminoma and 8 cases of mixed germ cell tumor. Secondary fertility-sparing cytoreductive surgery was performed in 31 cases, and secondary cytoreductive surgery without fertility-sparing was performed in 8 cases. During the median follow-up of 30.3 months after recurrence, 2 cases were loss to follow-up, 13 cases(33.3%)had a second relapse, and 10 patients(25.6%)died. The 5-year survival rate after recurrence was 68.7%, and the 5-year progress-free survival rate after recurrence 山 东 大 学 学 报 (医 学 版)56卷5期 -王瑾晖,等.复发和未控卵巢恶性生殖细胞肿瘤保留生育功能的治疗 \=-was 71.5%. FIGO stage and patients satisfaction with cytoreductive surgery were the independent prognostic factors(P<0.05). Conclusion The standardized primary therapy should be emphasized in the treatment of MOGCT. For recurrent and uncontrolled MOGCT, optimal cytoreductive surgery and adjuvant standardized chemotherapy have significant impacts on the prognosis of patients. For young nulliparous patients, secondary fertility-sparing salvage therapy can be taken into consideration.

Key words: Malignant ovarian germ cell tumor, Recurrence, Uncontrolled tumor, Chemoherapy, Salvage surgery

CLC Number: 

  • R737.31
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