8-year analysis of the prevalence of lymph nodes metastasis, oncologic and pregnancy outcomes in apparent early-stage malignant ovarian germ cell tumors.
OBJECTIVE
To determine the rate of lymph node metastasis, oncologic and pregnancy outcomes in apparent early-stage malignant ovarian germ cell tumor (MOGCT).


METHODS
Medical records of apparent early-stage MOGCT patients undergoing primary surgical treatment at Siriraj Hospital, Bangkok, Thailand, between January 2006 and December 2013, were retrospectively reviewed.


RESULTS
Thirty-eight patients had apparent stage I-II MOGCT. The mean age was 22.1±7.7 years (median, 20.8 years; range, 7.7-35.6 years). The mean tumor size was 17.8±6.5 cm with a median of 20 (range 4-30) cm. Three most common histopathologies were dysgerminoma (12 patients, 31.6%), immature teratoma (12 patients, 31.6%), and endodermal sinus tumor (6 patients, 15.8%). Twenty-seven of 38 patients underwent lymphadenectomy; 13 patients (48.2%) were stage IA and 8 patients (29.6%) were stage IC. The rate of retroperitoneal nodes metastasis was 7.4% (2/27 patients). At 26.1 months of median follow-up time (range 1.9-88.5 months), 9 patients retained fertility functions, with uneventful pregnancies in 3 of these. Only one patient (2.6%) had progression of disease at 4.9 months after surgery. The 5-year survival rate was 97.4%.


CONCLUSIONS
As the rate of pelvic or para-aortic node metastasis in MOGCT is considerable, lymphadenectomy should be incorporated in surgical staging procedures.
Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand E-mail : irene_siriraj@yahoo.com.
Usanee
U
Chatchotikawong
Irene
I
Ruengkhachorn
Chairat
C
Leelaphatanadit
Nisarat
N
Phithakwatchara
D000293:Adolescent; D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012186:Retroperitoneal Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D062606:Tertiary Care Centers; D013785:Thailand; D013997:Time Factors; D055815:Young Adult