title: Pure dysgerminoma of the ovary: a single institutional experience of 65 patients.
abstract: Ovarian dysgerminomas are rare entity and account for only about 2% of all malignant ovarian neoplasm. The aim of this study was to evaluate the clinicopathologic characteristics, treatment, long-term survival, and fertility outcome of women diagnosed with ovarian dysgerminoma at our institution. Sixty-five women with histologically proven pure ovarian dysgerminoma were identified in this retrospective study. They were treated at King Faisal Specialist Hospital, Riyadh; Saudi Arabia between 1976 and 2010. The median age was 20 years. The most frequent symptoms at presentation were abdominal pain and abdominal/pelvic mass. Thirty-three patients (50.7%) presented with stage I, 2 (3.1%) had stage II, 22 (33.8%) had stage III, and 4 (6.2%) had stage IV (4 unknown stage). Unilateral oophorectomy was performed in 50 patients (76.9%) while bilateral oophorectomy±hysterectomy was done in 12 patients (18.4%). Three patients had biopsy only. Forty patients (61.5%) received only chemotherapy, and 4 patients (6.2%) received radiotherapy alone. Recurrence was observed in 6 patients (9.2%). With median follow-up of 54 months, the 5-year disease-free survival (DFS) and overall survival (OS) were 88 and 95%, respectively. On univariate analysis, adjuvant chemotherapy was independent better prognostic factor for DFS (HR, 0.09; 95% CI, 0.01-0.84; P=0.034). Of the 50 patients treated with fertility-sparing surgery, 16 patients (32%) achieved pregnancy with 14 live births. Patients with pure ovarian dysgerminoma have excellent long-term outcome. There is no difference at outcome between fertility-sparing and nonconservative surgeries. Adjuvant chemotherapy was associated with significant improvement in DFS. It is possible to maintain good reproductive function after conservative surgery followed by chemotherapy in our series.
authors.affiliation: Department of Oncology, King Faisal Specialist Hospital, Riyadh, Saudi Arabia. hhussaini@gmail.com
authors.forename: Hamed
authors.initials: H
authors.lastname: A L Husaini
authors.forename: Hussein
authors.initials: H
authors.lastname: Soudy
authors.forename: Alaa
authors.initials: A
authors.lastname: El Din Darwish
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ahmed
authors.forename: Amin
authors.initials: A
authors.lastname: Eltigani
authors.forename: Mustafa
authors.initials: M
authors.lastname: A L Mubarak
authors.forename: Amal Abu
authors.initials: AA
authors.lastname: Sabaa
authors.forename: Wael
authors.initials: W
authors.lastname: Edesa
authors.forename: Taher
authors.initials: T
authors.lastname: A L-Tweigeri
authors.forename: Ismail A
authors.initials: IA
authors.lastname: Al-Badawi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004407:Dysgerminoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*