Immature teratoma of ovary - outcome following primary and secondary surgery: study of a single institution cohort
Immature teratoma of ovary - outcome following primary and secondary surgery: study of a single institution cohort
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DOI：
10.1016/j.ejogrb.2015.06.017
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发表时间：
2015-09-01
影响因子：
2.6
通讯作者：
Bafna, Uttam D.
中科院分区：
文献类型：
--
作者：
Reddihalli, Pallavi V.;Subbian, Anbukkani;Bafna, Uttam D.
目的：分析卵巢未成熟畸胎瘤的临床表现、治疗方法、原发和继发畸形及复发的转归。研究设计：对1999年至2011年间在妇科肿瘤科就诊的24例卵巢未成熟畸胎瘤患者进行回顾性分析。患者的临床表现、手术和化疗细节被包括在数据库中。还注意到了关于复发和管理以及未来结果的后续细节。总存活率从登记之日到最后一次随访或死亡之日计算。采用Kaplan-Meier法构建生存曲线。结果：未成熟畸胎瘤占218例恶性生殖细胞肿瘤的11%。在24例患者中，疼痛是主要症状，腹部肿块是最常见的临床表现。I期肿瘤16例，3级肿瘤占43%。6例患者仅行单侧输卵管卵巢切除术，未进行分期。12名患者接受了分期，其中最常见的手术是大网膜切除术。除一人外，所有患者均接受了以顺铂为基础的联合化疗。6例患者进行了二次复发清除手术。大多数复发记录在III期，较高级别的肿瘤。通过二次细胞减少术和以铂为基础的化疗，也有可能挽救大多数复发。平均随访39个月，总存活率为91.6%。结论：大多数患者在生存、月经和生殖功能方面，保守手术效果良好。以铂为基础的化疗适用于高级别和高分期的肿瘤，因为复发通常发生在这一亚组患者中。复发可通过选择二次细胞减灭术和以铂为基础的化疗来挽救。(C)2015爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: To analyse the clinical presentation, treatment - primary and secondary debulking and outcomes with focus on recurrences in ovarian immature teratoma.Study design: This is a single institution, retrospective analysis of 24 women who presented to a gynecologic oncology unit from 1999 to 2011 with ovarian immature teratoma. Patient's clinical presentation, operative and chemotherapy details were included in a database. Follow up details regarding recurrence and management and future outcomes were also noted. Overall survival was calculated from the date of registration to last follow up or date of death. Survival curve was constructed by Kaplan-Meier method.Results: Immature teratoma accounted for 11% of 218 malignant germ cell tumors. Of the 24 patients, pain was the predominant symptom and abdominal mass was the commonest clinical presentation. Sixteen out of 24 patients presented in Stage I and grade 3 tumors were found in 43% of patients. Six patients had only unilateral salpingo oophorectomy and no staging procedure. Twelve patients underwent staging, with omentectomy being the commonest procedure. All but one, had cisplatin based combination chemotherapy. Six patients underwent secondary debulking of recurrence. Most recurrences were recorded in Stage III, higher grade tumors. With secondary cytoreduction and platinum based chemotherapy, it was possible to salvage most recurrences as well. Overall survival after a mean follow-up of 39 months was 91.6%.Conclusion: Majority of the patients did well with conservative surgery in terms of survival, menstrual and reproductive function. Platinum based chemotherapy was indicated in higher grade and higher stage tumors as recurrences commonly occurred in this subgroup of patients. Recurrences could be salvaged with selected secondary cytoreduction and platinum based chemotherapy. (C) 2015 Elsevier Ireland Ltd. All rights reserved.