Clinical Characteristics and Treatment Outcomes of Patients with Ovarian Germ Cell Tumor Treated at a Tertiary Care Cent
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ORIGINAL ARTICLE
Clinical Characteristics and Treatment Outcomes of Patients with Ovarian Germ Cell Tumor Treated at a Tertiary Care Center in Patna, India Pritanjali Singh1 • Dharmendra Singh1
•
Monika Anant2 • Mukta Agrawal2 • Ruchi Sinha3
Received: 10 February 2020 / Revised: 24 April 2020 / Accepted: 29 April 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Purpose Ovarian germ cell tumors are rare tumors, mainly diagnosed in young females with a good prognosis if presented earlier. The objective of this study was to evaluate the clinicopathological features, treatment and outcome of the malignant ovarian germ cell tumors. Methods We retrospectively reviewed 37 patients of malignant ovarian germ cell tumors registered at the Department of Radiation Oncology All India Institute of Medical Sciences (AIIMS), Patna, from August 2014 to September 2019, and analyzed their demographic profile, treatment, outcome and survival. Results The median age at presentation was 15 years with a median duration of symptoms of 18 weeks. Abdominal pain and abdominal pain with lump were the main presenting symptoms of 45.9% and 45.9%, respectively. The median prechemotherapy value of AFP was 286 ng/ml, bHCG was 8.2 mIU/ml, and LDH was 470 U/L. Fertility-preserving surgery was done in 64.9% of cases. 35.1%, 21.6%, 29.7% and 13.5% cases were in stage I, stage II, stage III and stage IV, respectively. Adjuvant systemic chemotherapy was indicated in 94.6%, and chemotherapy was not indicated in 5.4% of patients. Non-dysgerminoma was the most common histopathological type (67.7%) followed by mixed germ cell tumors and dysgerminoma in 18.9% and 13.5%, respectively. The mean follow-up duration was 40 months, 32.4% of patients developed recurrence, and mean time to recurrence was 25 months. Conclusion Malignant ovarian germ cell tumor is a treatable disease, and selected patients may be managed with fertilitypreserving surgery. It was observed in this study that malignant ovarian germ cell tumors have a good prognosis. Keywords Malignant germ cell tumor Prognosis Non-dysgerminoma Ovarian malignancy
Introduction & Dharmendra Singh [email protected] Pritanjali Singh [email protected] Monika Anant [email protected] Mukta Agrawal [email protected] Ruchi Sinha [email protected] 1
Department of Radiotherapy, AIIMS, Patna, India
2
Department of Obstetrics and Gynecology, AIIMS, Patna, India
3
Department of Pathology, AIIMS, Patna, India
Ovarian malignancies arising from non-epithelial origin account for about 10% of all ovarian cancers [1]. Five percent of all ovarian cancer represents the malignant germ cell tumors. Younger age-groups are most commonly involved. The incidence of ovarian germ cell tumors may be as high as 15% in Blacks and Asians [2]. Malignant ovarian germ cell tumors are broadly divided into dysgerminoma and non-dysgerminoma. Dysgerminomas are derived from activated germ cells, while non-dysgerminomas are derived from tumors of totipotent cells of the ov
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