Cystectomy for immature teratoma of the ovary.
OBJECTIVE
Most patients with malignant ovarian germ cell tumors (MOGCT) of the ovary are in their reproductive years and wish to preserve fertility. Because of the excellent response to chemotherapy, the standard of care is unilateral salpingo-oophorectomy (USO), but some patients undergo cystectomy only before final pathology. In view of the lack of information concerning the outcome following cystectomy in germ cell tumors, we retrospectively evaluated the clinical outcome of patients who underwent cystectomy only as part of their surgical treatment.


METHODS
The clinical and pathological records of 38 patients diagnosed with MOGCT, treated and followed in the department of gynecologic oncology were reviewed. Eight patients underwent cystectomy only at their initial surgery and are the subjects of this study.


RESULTS
All the eight patients who underwent cystectomy were diagnosed with immature teratoma (three grade 1, four grade 2, and one grade 3) on final pathology following surgery. All except three patients (two with grade 1 and one with grade 2 disease) received adjuvant chemotherapy. Follow-up was available for all the patients, with a median duration of 4.7 years. No recurrences were observed during this period. Three patients delivered a total of seven babies.


CONCLUSIONS
Cystectomy followed by adjuvant chemotherapy appeared satisfactory for apparent early-stage immature teratoma when close follow-up was carried out. It is still unclear whether cystectomy alone will also be safe. Further studies will need to address this issue.
Beiner
Mario E
ME
Department of Gynecologic Oncology, The Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, 52621, Israel. lmbeiner@zahav.net.il
Gotlieb
Walter H
WH
Korach
Yaacov
Y
Shrim
Alon
A
Stockheim
David
D
Segal
Yaacov
Y
Fridman
Eduard
E
Ben-Baruch
Gilad
G
D000293:Adolescent; D000328:Adult; D017024:Chemotherapy, Adjuvant; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013724:Teratoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome