Outcome and Risk Factors for Recurrence in Malignant Ovarian Germ Cell Tumors A MITO-9 Retrospective Study
Outcome and Risk Factors for Recurrence in Malignant Ovarian Germ Cell Tumors A MITO-9 Retrospective Study
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DOI：
10.1097/igc.0b013e3182236582
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发表时间：
2011-11-01
影响因子：
4.8
通讯作者：
Lorusso, Domenica
中科院分区：
文献类型：
--
作者：
Mangili, Giorgia;Sigismondi, Cristina;Lorusso, Domenica
目的：本研究旨在探讨恶性卵巢生殖细胞肿瘤（MOGCTs）患者的预后，并确定复发的危险因素。方法：共123例MOGCTs患者进行了回顾性分析MITO中心。81名患者在MITO中心接受了初步治疗，而其他42名患者则接受了辅助化疗或复发。结果：中位年龄为24岁（范围，11-76岁）。其中无性细胞瘤49例（39.8%），未成熟畸胎瘤35例（28.5%），混合性生殖细胞瘤12例（9.8%），卵黄囊瘤26例（21.1%），胚胎癌1例（0.8%）。国际妇产科联合会分期分布如下：I期，87例（70.7%）; II期，3例（2.4%）; III期，29例（23.6%）; IV期，4例（3.3%）。92例患者进行了保留生育能力的手术，而其余31例接受了根治性手术; 65.8%的患者接受了辅助化疗。复发率为17.8%，中位复发时间为9个月。单变量和多变量分析显示，患者年龄（945岁）和转诊（MITO）中心外治疗是复发的最重要预测因素。5年总生存率为88.8%，中位随访时间为61个月。单因素和多因素分析表明，大于I期和卵黄囊肿瘤是独立的不良预后indicator.Conclusions：这项研究证实，MOGCT具有良好的预后，与5年总生存率为95.6%和73.2%，在I期和晚期，分别。年龄大于45岁和未在转诊中心接受治疗是复发的独立危险因素，而大于I期和卵黄囊组织学是独立的不良预后指标。
Aims: This study aimed to investigate the outcome of patients with malignant ovarian germ cell tumors (MOGCTs) and to define the risk factors for recurrence.Methods: A total of 123 patients with MOGCTs were retrospectively reviewed among MITO centers. Eighty-one patients had primary treatment in a MITO center, whereas the other 42 were referred for adjuvant chemotherapy or recurrence. The clinicopathologic characteristics were evaluated for association with relapse or death.Results: Median age was 24 years (range, 11-76 years). Forty-nine (39.8%) had dysgerminomas, 35 (28.5%) had immature teratomas, 12 (9.8%) had mixed germ cell tumors, 26 (21.1%) had yolk sac tumors, and 1 (0.8%) had embryonal carcinoma. International Federation of Gynecology and Obstetrics stage distribution was as follows: stage I, 87 (70.7%); stage II, 3 (2.4%); stage III, 29 (23.6%); and stage IV, 4 (3.3%). Fertility-sparing surgery was performed in 92 patients, whereas the remaining 31 received radical surgery; 65.8% of patients received adjuvant chemotherapy. Recurrence rate was 17.8% and the median time to recurrence was 9 months. Univariate and multivariate analyses showed that patient age (945 years) and treatment outside a referral (MITO) center were the most important predictors of recurrence. The 5-year overall survival rate was 88.8%, with a median follow-up of 61 months. Univariate and multivariate analyses demonstrated that stage greater than I and yolk sac tumors were independent poor prognostic indicators.Conclusions: This study confirms that MOGCTs have excellent prognosis, with 5-year overall survival rates of 95.6% and 73.2% in stage I and advanced stages, respectively. Age older than 45 years and treatment not in a referral center are independent risk factors for recurrence, whereas stage greater than I and yolk sac histology are independent poor prognostic indicators.