Outcomes of Surgery Alone and Surveillance Strategy in Young Women With Stage I Malignant Ovarian Germ Cell Tumors.
This study aimed to evaluate the safety of surgery alone followed by surveillance in young women with stage I malignant ovarian germ cell tumor (MOGCT).



A retrospective review was performed on 31 patients with stage I MOGCT who were treated by surgery alone with follow-up.



The median patient age was 22 years (range, 6-45 years). The histological type was dysgerminoma in 17, immature teratoma in 11, yolk sac tumor in 1, and mixed MOGCT in 2 cases. Seventeen patients were stage IA, 1 was IB, and 13 were IC. All patients underwent fertility-sparing surgery, which involved either unilateral salpingo-oophorectomy or oophorectomy. Additionally, 12 (38.7%) patients underwent cystectomy of the contralateral ovary, but only 1 patient had MOGCT in the contralateral ovary. Twenty (65%) patients underwent a complete staging operation that included peritoneal exploration, biopsy, cytology, and/or omentectomy or omental biopsy; 7 (22.6%) patients who underwent pelvic and para-aortic lymphadenectomy. After a median follow-up time of 137 months (range, 24-268 months), 7 (22.6%) patients had recurrent disease, and underwent secondary surgery followed by chemotherapy with bleomycin, etoposide, and cisplatin (BEP). Six (86%) patients were successfully salvaged, but 1 died of disease progression. The 10-year disease-free survival rate was 77%, but the 10-year overall survival rate was 97%.



Fertility-sparing surgery alone with surveillance could be a safe treatment strategy. Most recurrence can be successfully salvaged by surgery and BEP chemotherapy and the overall survival is not compromised. Using this strategy, 77.4% of patients may avoid unnecessary BEP chemotherapy.
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Jeong-Yeol
JY
Park
Dae-Yeon
DY
Kim
Dae-Shik
DS
Suh
Jong-Hyeok
JH
Kim
Yong-Man
YM
Kim
Young-Tak
YT
Kim
Joo-Hyun
JH
Nam
D000293:Adolescent; D000328:Adult; D002648:Child; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult