title: Prognostic factors of germ cell and sex cord-stromal ovarian tumors in pediatric age: 5 years experience.
abstract: BACKGROUND
  Ovarian tumors in the pediatric age group are not infrequent. Germ-cell tumors are the commonest ovarian neoplasm in the first two decades of life. Sex cord-stromal tumors are the most common ovarian tumors to cause precocious puberty in girls.
  
  
  METHODS
  This retrospective study included all managed cases of malignant germ-cell and sex cord-stromal tumors in the pediatric age (less than 18 years). The medical records of the admitted cases from first of January, 2008 to 31 December, 2012 were reviewed and the following information was collected: patient age, clinical presentation, surgical stage, tumor histology, therapy, clinical course, and outcome. Serum alpha-fetoprotien on admission was studied.
  
  
  RESULTS
  The study included 42 pediatric cases of germ-cell and granulosa cell tumors of the ovary. Mean age of the cases was 11.26 years (range: 7-15 years). Abdominal pain was the commonest presentation. Twenty-two cases (52.4%) were diagnosed as stage I disease. Twenty-eight cases (66.7%) were exposed to fertility sparing surgery. Age of the patient and site of tumor were significantly correlated to the survival (p value: 0.04 & 0.09 respectively). The correlations of stage of the disease, use of pre-operative chemotherapy, and type of surgical interference were highly significant (P value: 0.007, 0.001, and 0.001 respectively). Tumor size and histologic types were not significantly correlated to survival (P value: 0.19 & 0.67 respectively).
  
  
  CONCLUSIONS
  The cumulative survival rate was 76.2%. The correlations of stage of the disease, use of pre-operative chemotherapy, and type of surgical interference were highly significant. Tumor size and histologic types were not significantly correlated to survival. Initial level of alpha-fetoprotein was not significantly correlated to survival or recurrence.
authors.affiliation: Pediatric Oncology Department, Mansoura Oncology Center, Egypt
authors.forename: Rasha
authors.initials: R
authors.lastname: Elashry
authors.affiliation: Department of Obstetrics and Gynecology, Mansoura University, Egypt.
authors.forename: Reda
authors.initials: R
authors.lastname: Hemida
authors.affiliation: Department of Obstetrics and Gynecology, Mansoura University, Egypt.
authors.forename: Hosam
authors.initials: H
authors.lastname: Goda
authors.affiliation: Department of Obstetrics and Gynecology, Mansoura University, Egypt.
authors.forename: El-Said
authors.initials: el-S
authors.lastname: Abdel-Hady
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D018312:Sex Cord-Gonadal Stromal Tumors / Q000401:mortality* / Q000473:pathology / Q000628:therapy