Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2022; 13(10): 802-812
Published online Oct 24, 2022. doi: 10.5306/wjco.v13.i10.802
Oncology and reproductive outcomes over 16 years of malignant ovarian germ cell tumors treated by fertility sparing surgery
Muangloei Rungoutok, Prapaporn Suprasert
Muangloei Rungoutok, Prapaporn Suprasert, Department of Obstetrics and Gynecology, Chiang Mai University, Muang 50200, Chiang Mai, Thailand
Author contributions: Rungoutok M and Suprasert P contributed equally to this work; Suprasert P designed the research study; Rungoutok M and Suprasert P performed the research and contributed analytic tools; Suprasert P analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by Chiang Mai University Ethic Committees (Research ID: 7736; Study Code: OBG-2563-07736).
Informed consent statement: Patients were not required to give informed consent for the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no potential conflict of interest for the article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at psuprase@gmail.com. Participants consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Prapaporn Suprasert, MD, Associate Professor, Department of Obstetrics and Gynecology, Chiang Mai University, 110 Inthawarorod Road, Muang 50200, Chiang Mai, Thailand. psuprase@gmail.com
Received: July 7, 2022
Peer-review started: July 7, 2022
First decision: August 22, 2022
Revised: August 26, 2022
Accepted: September 9, 2022
Article in press: September 9, 2022
Published online: October 24, 2022
Processing time: 104 Days and 21.4 Hours
ARTICLE HIGHLIGHTS
Research background

Malignant ovarian germ cell tumors (MOGCT) are rare and frequently occur in women of young and reproductive age. Fertility-sparing surgery (FSS) is the main treatment for these patients. However, oncologic and reproductive outcomes after FSS for this disease are still limited.

Research motivation

Due to the limited data on oncology and reproductive outcomes of FSS especially in Southeast Asia, this study was conducted to identify these outcomes of MOGCT patients who were treated by FSS.

Research objectives

To evaluate the oncology and reproductive outcomes of MOGCT who underwent FSS.

Research methods

All MOGCT patients who underwent FSS defined as the operation with a preserved uterus and at least one side of the ovary at our institute between January 2005 and December 2020 were retrospectively reviewed.

Research results

Sixty-two patients were reviewed in this study. The median age was 22 years old and over 77% were nulliparous. The three most common histology findings were immature teratoma (32.2%), dysgerminoma (24.2%), and yolk sac tumor (24.2%). The distribution of stage was as follows: Stage I, 74.8%; stage II, 9.7%; stage III, 11.3%; stage IV, 4.8%. About 2/3 of the patients received adjuvant chemotherapy. With a median follow-up time of 96.3 mo, the 10-year progression-free survival and overall survival were 82.4% and 91%, respectively. For reproductive outcomes, of 43 patients who received adjuvant chemotherapy, 18 (41.9%) had normal menstruation and 17 (39.5%) resumed menstruation with a median time of 4 mo. Of about 14 patients who desired to conceive, four were pregnant and delivered good outcomes. Only one case was aborted. Therefore, the successful pregnancy rate was 28.6%.

Research conclusions

The oncology and reproductive outcomes of MOGCT treated by FSS were excellent. Many patients showed a long survival time with normal menstruation. However, the obstetric outcome was not quite high.

Research perspectives

The strength of our study was the real-world series of patients with MOGCT treated by FSS in a single institute to show the oncology and reproductive outcomes. However, with the limitation of the retrospective study, about 2/3 of the patients were not followed for a long time. Therefore, some data were missed. A good plan follow-up is needed in the future.