| Purpose:Ovarian malignant germ cell tumors(MOGCT)often occur in adolescent women.With the improvement of surgical methods and the application of combined chemotherapy in recent years,the prognosis of patients with MOGCT has greatly improved.This article retrospectively analyzes the clinical characteristics of 76 patients with MOGCT,studies the relevant factors affecting the prognosis of MOGCT,and evaluates the effect of fertility-preserving treatment on patient fertility outcomes.Methods : We collected and arranged 76 patients with MOGCT admitted to Shengjing Hospital affiliated to China Medical University from January 1,2011 to August 30,2017.By studying the relevant clinical materials of patients,follow-up on the phone to understand the patient’s survival and menstrual recovery and fertility status.Retrospective analysis of the patients’ FIGO stage,pathological type,surgical method,postoperative chemotherapy and other factors on the survival rate and pregnancy outcome.Results:1、Among the 76 patients,the age of onset was 7-48 years,the average age of onset was 22.29 years,and the median age of onset was 23 years.Most of the patients were admitted to the hospital with 35 cases of abdominal pain(46.05%)and 25 cases of lower abdominal mass(32.89%)as the first symptom.2、The clinical pathological types of 76 cases of MOGCT were divided into: 32 cases of immature teratoma(42.11%),21 cases of dysgerminoma tumor(27.63%),18 cases of endodermal sinus tumor(23.68%),and 5 cases of mixed germ cell tumor(6.58%).According to FIGO staging,59 cases were stage I,5 cases were stage II,11 cases were stage III,and 1 case was stage IV.3、All76 patients underwent surgical treatment and were divided into two groups according to whether they had undergone fertility-preserving surgery.70 patients(92.11%)underwent fertility-preserving surgery,and 6 patients(7.89%)underwent fertility-preserving surgery.Among them,27 patients(38.57%)underwent full-stage staging surgery,19 patients(27.14%)underwent full-stage staging surgery,10 patients(14.29%)underwent ovarian tumor resection,and 14 patients(20.00%)with one side accessory resection).4、There were 49 patients with postoperative chemotherapy,43 patients with chemotherapy course≤4 times,6 patients with 4 <treatment course ≤7 times,most of the chemotherapy regimens were PEB regimens(73.47%).5、The follow-up time was 22-94 months.At the end of the follow-up,11 patients relapsed and 1 died.The survival time of the dead patient was 14 months.Among the 11 people with fertility needs,5 cases had a total of 6pregnancies,2 full-term deliveries,and 1 miscarriage.3 cases were in pregnancy during follow-up,and the pregnancy rate was 54.55%.All 46 patients returned to normal menstruation after chemotherapy.6 、 In this study,a statistical analysis of the factors affecting recurrence was carried out.The recurrence rates of patients with dysgerminoma tumors and non-dysgerminoma tumors were 28.6% and 9.1%,the difference was statistically significant(P = 0.046);Postoperative treatment was divided into two groups:adjuvant chemotherapy and non-adjuvant chemotherapy.The recurrence rates were 2.0%and 52.6%,respectively,with a significant difference(P = 0.000).Fisher’s exact analysis of the pregnancy status of patients with pregnancy needs,there was no significant difference in pregnancy rate between FIGO stage,different surgical methods,with or without postoperative adjuvant chemotherapy,and pathological types(P = 0.545,P =0.567,P = 0.061,P = 0.652).Conclusion: 1 、 MOGCT mostly occurs in adolescent women.The most common clinical symptoms include abdominal distension and abdominal pain and pelvic mass.2、Pathological types and whether chemotherapy is standardized after surgery are factors that affect disease recurrence;3、For young patients with fertility needs,surgical treatment to preserve fertility is feasible.Surgical methods,pathological types,clinical staging,and standard chemotherapy have no significant effect on the pregnancy rate.Postoperative standard chemotherapy plays an important role in treatment. |
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