title: The influence of age and other prognostic factors associated with survival of ovarian immature teratoma - A study of 1307 patients.
abstract: To determine impact of age and other prognostic factors on the survival of ovarian immature teratoma (IT) patients.
  
  
  
  Data obtained from the SEER database between 1973 and 2012. Kaplan-Meier methods and multivariate Cox regression models were used for statistical analyses.
  
  
  
  Of 1307 patients (median: 24years; range: 0-93), 78%, 5%, 13%, 4% were stages I, II, III and IV, respectively. 25%, 35%, and 40% had grades 1, 2, and 3. Whites were less likely to be diagnosed, and Asians had a nearly 3-fold higher proportion of IT compared to the proportion of Asians in the U.S. census. The 5-year disease-specific survival (DSS) was 91.2%. Those with stages I, II, III and IV disease had survivals of 99.7%, 95%, 81%, and 71.8% (p<0.001) and grades 1, 2, and 3 had DSS of 98.7%, 95.8%, and 91% (p<0.001), respectively. Of those who underwent fertility-preserving surgery, the DSS was 98.8%. Over time from 1973 to 1986, to 1987-1999, to 2000-2012, the survivals were 76.4%, 92.8%, and 94.7% (p<0.001). Of stage I patients, no patient <18years (n=214, used as adult cutoff) and 2 of 283 patients >18years died of cancer, with corresponding 5years DSS of 100% vs. 99.6% (p>0.05). Older age (by year, HR: 1.05; 95% CI: 1.04-1.06; p<0.0001) and higher stage (HR: 11.52; 95% CI: 4.08-32.48; p<0.0001) were independent factors indicating poorer survival.
  
  
  
  The outcome of patients with stage I disease was excellent at 99.7%, with children and adults having corresponding survivals of 100% and 99.6%.
authors.affiliation: Division of Gynecologic Oncology, California Pacific Palo Alto Medical Foundation, San Francisco, CA, USA. Electronic address: chanjohn@sutterhealth.org.
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
authors.affiliation: Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
authors.forename: Austin B
authors.initials: AB
authors.lastname: Gardner
authors.affiliation: Division of Gynecologic Oncology, California Pacific Palo Alto Medical Foundation, San Francisco, CA, USA.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Chan
authors.affiliation: Division of Gynecologic Oncology, California Pacific Palo Alto Medical Foundation, San Francisco, CA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Guan
authors.affiliation: Division of Gynecologic Oncology, California Pacific Palo Alto Medical Foundation, San Francisco, CA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Alshak
authors.affiliation: Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kapp
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D018426:SEER Program; D013724:Teratoma / Q000208:ethnology / Q000401:mortality* / Q000473:pathology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Germ cell tumor; Immature teratoma; Ovarian cancer; Prognostic factors