Reproductive outcomes of 105 malignant ovarian germ cell tumor survivors: a multicenter study
Reproductive outcomes of 105 malignant ovarian germ cell tumor survivors: a multicenter study
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DOI：
10.1016/j.ajog.2018.07.021
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发表时间：
2018-10-01
影响因子：
9.8
通讯作者：
Kikkawa, Fumitaka
中科院分区：
文献类型：
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作者：
Tamauchi, Satoshi;Kajiyama, Hiroaki;Kikkawa, Fumitaka
背景：卵巢恶性生殖细胞肿瘤好发于年轻女性。直到20世纪70年代，在系统化疗建立之前，恶性卵巢生殖细胞肿瘤的预后非常差。最近，预后有所改善，希望怀孕的患者正在采用保留生育力的治疗。然而，恶性卵巢生殖细胞肿瘤的幸存者谁实际上成为pregnancy.OBJECTIVE：本研究的目的是澄清生殖结果的恶性卵巢生殖细胞肿瘤幸存者使用的数据来自多中心数据库和额外的调查生殖outcomes.Study设计：本研究使用的东海卵巢肿瘤研究组数据库的卵巢癌患者。我们评估了1986年至2016年的数据库，并选择了接受生育保留治疗的40岁以下恶性卵巢生殖细胞肿瘤患者。向登记的设施发送了关于生殖结果的资料。本研究收集并使用了以下数据：年龄、发病日期、外科手术、化疗方案、肿瘤类型、国际妇产科联合会分期、生存结局和周期、妊娠和分娩次数、婚姻状况、生育意愿、妊娠方法、分娩时孕周、婴儿出生体重、产科并发症，结果：共确定了110例接受生育保留治疗的恶性卵巢生殖细胞肿瘤患者。中位随访期为10.4年。5例患者因复发治疗后死亡或丧失生育能力而被排除。最终纳入105例患者。另一项调查显示，45名希望分娩的患者中有42人怀孕。40例卵巢恶性生殖细胞肿瘤存活者共妊娠65例，分娩56例婴儿。结论：卵巢恶性生殖细胞肿瘤存活者保留生育能力治疗后的生殖结局是有希望的。恶性卵巢生殖细胞肿瘤的幸存者可以怀孕，如果他们愿意的话。
BACKGROUND: Malignant ovarian germ cell tumors usually occur in young women. Until the 1970s, before establishment of systemic chemotherapy, malignant ovarian germ cell tumors had a very poor prognosis. Recently, prognosis has improved, and fertility-sparing treatment is being adopted in patients who desire to become pregnant. However, the number of malignant ovarian germ cell tumor survivors who actually became pregnant remains unknown.OBJECTIVE: The present study aimed to clarify the reproductive outcomes in malignant ovarian germ cell tumor survivors by using data from a multicenter database and an additional survey on reproductive outcomes.STUDY DESIGN: The study used the Tokai Ovarian Tumor Study Group database on ovarian cancer patients. We assessed the database from 1986 through 2016 and selected malignant ovarian germ cell tumor patients < 40 years of age who received fertility-sparing treatment. Questionnaires on reproductive outcomes were sent to the registered facilities. The following data were collected and used in this study: age, date of onset, surgical procedure, chemotherapy regimen, tumor type, International Federation of Gynecology and Obstetrics stage, survival outcome and period, number of pregnancies and childbirths, marital status, childbearing desire, method of pregnancy, gestational weeks at delivery, birthweight of the baby, obstetric complications, and menstrual status after fertility-sparing treatment.RESULTS: A total of 110 malignant ovarian germ cell tumor patients who received fertility-sparing treatment were identified. The median follow-up period was 10.4 years. Five patients were excluded because of death or loss of fertility after treatment for recurrence. Thus, 105 patients were finally included. The additional survey revealed that 42 of 45 patients who desired childbirth became pregnant. The total number of pregnancies was 65, and 56 babies were born to 40 malignant ovarian germ cell tumor survivors.CONCLUSION: The reproductive outcomes of malignant ovarian germ cell tumor survivor are promising with fertility-sparing treatment. Malignant ovarian germ cell tumor survivors can become pregnant and give birth if they desire.