Retrospective Analysis Of Clinical Feature And Prognosis Of Ovarian Cancer In Adolescents And Young Adults

Objectives:By reviewing the clinical data of adolescents and young adults(AYA)with ovarian cancer,we analyzed their clinical characteristics,treatment,and prognosis,to discuss the management of them and provide a reference for individualized diagnosis as well as treatment of such patients.Methods:The clinical data of 332 AYA with ovarian cancer(including the general situation,complaints,menstrual and fertility history,family history,serological tumor markers and imaging examination,surgical methods,pathological staging,and postoperative treatment)were collected.Patients were from Qilu Hospital of Shandong University,the Affiliated Hospital of Qingdao University,and Weifang People’s Hospital.The postoperative adjuvant therapy,recurrence,and whether to death were followed up.At the same time,the information of ovarian cancer patients aged 15-39 years old in the SEER(Surveillance,Epidemiology,and End Results)database was extracted.Statistical analysis was performed on the above two parts of data to explore the clinical characteristics and prognostic factors of patients with AYA ovarian malignant tumors.Results:1.Clinical and pathological characteristics:According to the data of the research center,there were statistical differences in marital status,tumor location,Federation International of Gynecology and Obstetrics(FIGO)stage,pathological type,and tumor differentiation between patients aged 15-25 and 26-39 years old(P<0.05).Compared with patients aged 26-39 years old,patients aged 15-25 years old were mostly unmarried(85.2%),tumors were unilateral(92.6%),FIGO stage was mostly stage I(73.8%),the pathological type of ovarian malignant germ cell tumors(MOGCTs)accounted for a high proportion(54.9%),and the proportion of tumor differentiation was low(26.1%).The results of the SEER database showed that there were significant differences in race,marital status,tumor location,tumor diameter,FIGO stage,and pathological type between the 15-25 years old group and the 26-39 years old group(P<0.05).Compared with 26-39 years old group,the proportion of married in 15-25 years old group(18.8%)decreased,the proportion of tumors located in bilateral ovaries(11.8%)decreased,the proportion of tumor diameter>10cm(68.8%)increased,the proportion of FIGO stage I(65.5%)increased,the proportion of epithelial ovarian cancer(EOC)decreased(36.0%),and the proportion of MOGCTs(55.2%)increased.2.Treatment:According to the data of the research center,young people,FIGO stage I,and pathological type of malignant ovarian germ cell tumors(MOGCTs)are more likely to receive fertility-preserving surgery.For the postoperative adjuvant chemotherapy of MOGCTs patients,there was no significant difference in the effect of the TC regimen and BEP regimen on overall survival(OS)and progression-free survival(PFS)(P>0.05).The results of the SEER database showed that patients with young people,FIGO stage I,and pathological type of sex cord-stromal tumors(SCST)were more likely to undergo fertilitysparing surgery.3.Prognostic analysis:According to the data of the research center,the OS of the 15-25 age group was significantly better than those of the 26-39 age group,and there was no significant difference in the prognosis of patients with fertility preservation surgery(P>0.05).The SEER database also obtained the same results.The data of the research center showed that FIGO stage was an independent factor affecting OS and PFS in the total population.In the 15-25 age group,FIGO stage may affect OS,and postoperative adjuvant chemotherapy is an independent factor for PFS.In the 26-39 age group,FIGO stage was an independent factor affecting OS and PFS,According to the results of the SEER database,FIGO stage,pathological type,degree of differentiation,and lymph node status were independent influencing factors affecting OS in the total population,and similar results were drawn in the 26-39 age group.FIGO stage,pathological type,and degree of differentiation in the 15-25 age group were independent risk factors for OS.Conclusions:1.Compared with the 26-39 age group,the tumors in the 15-25 age group were mostly unilateral,with a low proportion of pathological type EOC,and a high proportion of MOGCTs.And the proportion of FIGO stage I was high.2.Patients with young people,FIGO stage I,and pathological type of non-epithelial ovarian cancer are more likely to undergo fertility-sparing surgery,and fertility-sparing surgery is safe.3.For AY A patients who need postoperative adjuvant therapy with MOGCTs,TC regimen may be an alternative to BEP regimen.4.FIGO stage,pathological type,and differentiation affect the prognosis of patients with AYA ovarian malignant tumors.In the 15-25 age group,the proportion of FIGO stage I is high,the proportion of pathological type EOC is low,the proportion of MOGCTs is high,and the proportion of tumor differentiation is low,so that the prognosis is better than that of the 26-39 age group.