| Objective: To analyze the clinical features,outcomes and prognostic factors of patients with ovarian malignant germ cell tumors.Methods: The clinical case data of 43 patients with MOGCTs who were admitted to the First Affiliated Hospital of Dalian Medical University from January 2006 to September 2018 were collected and reviewed by telephone.The treatment and recovery were retrospectively analyzed.Statistical analysis was performed using SPSS 21.0 software.Kaplan-Meier was used for single factor survival analysis,and log-rank method was used to compare the difference between survival curves.P<0.05 was statistically significant.Results: 1.Among the 43 cases of MOGCT,there were 18 cases of immature teratoma,7 cases of yolk sac tumor,6 cases of dysgerminoma,5 cases of mature teratoma malignant transformation,4 cases of mixed germ cell tumor,2 cases of embryonal carcinoma,1 case of primary choriocarcinoma.The median age of onset was 26 years.The clinical symptoms were mainly pelvic mass(39.5%)and abdominal distension and abdominal pain(48.8%).According to clinical pathological stage(FIGO2013),There were 32 cases(74.4%)of stage Ⅰ,4 cases(9.3%)in stage Ⅱ and 7 cases(16.3%)in stage Ⅲ.2.Surgical methods: 31 patients with fertility preservation surgery,12 patients with radical surgery;19 patients with retinal resection,accounting for 44.2%,24 patients without resection of the omentum,accounting for 55.8%;receiving pelvic cavity There were 14 cases of lymph node dissection,accounting for 32.6%,and 29 cases without pelvic lymphadenectomy,accounting for 67.4%.Among them,9 patients underwent comprehensive staging surgery.3.Postoperative chemotherapy: 26 patients received adjuvant chemotherapy;19 cases of the 31 patients with fertility preservation received chemotherapy,and the chemotherapy regimen was mainly BEP.4.Survival: Of the 43 patients,4 cases were lost to follow-up and 4 cases died(9.3%).Of the 4 cases deaths,1 case received preserved fertility;3 cases received radical surgery.One of the 35 survivors had tumor-bearing survival.The average survival time of patients was 135 months.5.Menstrual recovery and fertility: 1 case died,3 cases lost to follow-up,and 2 refused to be followed of the 31 patients who retained fertility.Of the 25 patients who were followed up,2 cases had no menstrual recovery,and others’ menstruation recovered in 2-4 months after the end of chemotherapy.There were 7 cases of fertility requirements,5 cases of pregnancy 6 times,5 times of full-term delivery,and 1 abortion;all offspring were healthy and without deformity.6.Factors affecting survival prognosis: In the univariate analysis,the survival rates of stage I and stage II were 100%,and the stage III survival rate was 50%.There was significant difference(P=0);the age of onset,histological type,Surgical methods,whether pelvic lymphadenectomy,resection of the omentum,and postoperative chemotherapy were not associated with prognosis.Conclusion: 1.The incidence of MOGCT tends to women of childbearing age,the median age of onset is 26 years old;and the main pathological types are ranked as immature teratoma,yolk sac tumor,and dysgerminoma according to the incidence rate from high to low;The main clinical symptoms of MOGCTs are abdominal mass,abdominal distension and abdominal pain;Most patients are in Phase I for the first visit;2.Surgery-pathological staging is associated with prognosis in patients with MOGCTs.Patients in stage I and II have a significantly better prognosis than stage III;3.This study demonstrates that preservation of fertility is feasible and does not support pelvic lymphadenectomy and omental resection. |
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