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8-year Analysis of the Prevalence of Lymph Nodes Metastasis, Oncologic and Pregnancy Outcomes in Apparent Early-Stage Malignant Ovarian Germ Cell Tumors

  • Chatchotikawong, Usanee (Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University) ;
  • Ruengkhachorn, Irene (Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University) ;
  • Leelaphatanadit, Chairat (Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University) ;
  • Phithakwatchara, Nisarat (Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University)
  • Published : 2015.03.09

Abstract

Purpose: To determine the rate of lymph node metastasis, oncologic and pregnancy outcomes in apparent early-stage malignant ovarian germ cell tumor (MOGCT). Materials and Methods: Medical records of apparent early-stage MOGCT patients undergoing primary surgical treatment at Siriraj Hospital, Bangkok, Thailand, between January 2006 and December 2013, were retrospectively reviewed. Results: Thirty-eight patients had apparent stage I-II MOGCT. The mean age was $22.1{\pm}7.7years$ (median, 20.8 years; range, 7.7-35.6 years). The mean tumor size was $17.8{\pm}6.5cm$ with a median of 20 (range 4-30) cm. Three most common histopathologies were dysgerminoma (12 patients, 31.6%), immature teratoma (12 patients, 31.6%), and endodermal sinus tumor (6 patients, 15.8%). Twenty-seven of 38 patients underwent lymphadenectomy; 13 patients (48.2%) were stage IA and 8 patients (29.6%) were stage IC. The rate of retroperitoneal nodes metastasis was 7.4% (2/27 patients). At 26.1 months of median follow-up time (range 1.9-88.5 months), 9 patients retained fertility functions, with uneventful pregnancies in 3 of these. Only one patient (2.6%) had progression of disease at 4.9 months after surgery. The 5-year survival rate was 97.4%. Conclusion: As the rate of pelvic or para-aortic node metastasis in MOGCT is considerable, lymphadenectomy should be incorporated in surgical staging procedures.

Keywords

Ovary germ cell tumors;lymph node;lymphadenectomy;pregnancy outcome

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