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Conservative surgical management of malignant ovarian germ cell tumors: the experience of the Gynecologic Oncology Unit at Ain Shams University.
Eur J Gynaecol Oncol. 2000; 21(6):605-9.EJ

Abstract

PURPOSE

To evaluate the role of extended surgical staging in patients with malignant ovarian germ cell tumors in the presence of cisplatinum-based combination chemotherapy.

MATERIALS & METHODS

16 patients aged between 13 and 40 years (mean 20.5) diagnosed and treated for malignant ovarian germ cell tumors at the Gynecologic Oncology Unit. Ain Shams University, during the period from May 1994 to October 1999.

RESULTS

Six patients were diagnosed with dysgerminoma, six with immature teratoma and four with endodermal sinus tumor. Only seven cases were primarily managed at the unit and were subjected to proper surgical staging as required by FIGO (two in each of the stages IC, IIC and IIIA and one in stage IV). However, the remaining nine cases were referred to the unit, six after having unilateral salpingo-oophorectomy and no surgical staging, one patient after total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO), and one with recurrent dysgerminoma in the retroperitoneum and mediastinum following suboptimal treatment. None of these cases were surgically re-explored and all including the first six cases were given the standard BEP chemotherapy for 4-6 courses (mean 5.8). Follow-up ranged from 7-72 months (mean 30.5). All patients are alive without any evidence of disease recurrence except for one patient with a stage IIIA immature teratoma who had a local and distant recurrence and is undergoing second-line chemotherapy. All patients have their menstrual function preserved except for three patients; one having 46,XX pure gonadal dysgenesis with a preoperative FSH level of 120 U/l and the eldest two patients having a TAH+BSO as they had completed their families. Three patients are currently pregnant.

CONCLUSION

In view of the high chemosensitivity and curability of ovarian germ cell tumors and their occurrence in young patients, every effort should be made to preserve one ovary and the uterus for future reproduction even in advanced cases. The role of revisional surgical staging, in particular retroperitoneal lymphadenectomy in light of these data and those of others should be redefined in the future.

Authors+Show Affiliations

Department of Ob/Gyn, Ain Shams University, Cairo, Egypt.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11214621

Citation

El-Lamie, I K., et al. "Conservative Surgical Management of Malignant Ovarian Germ Cell Tumors: the Experience of the Gynecologic Oncology Unit at Ain Shams University." European Journal of Gynaecological Oncology, vol. 21, no. 6, 2000, pp. 605-9.
El-Lamie IK, Shehata NA, Abou-Loz SK, et al. Conservative surgical management of malignant ovarian germ cell tumors: the experience of the Gynecologic Oncology Unit at Ain Shams University. Eur J Gynaecol Oncol. 2000;21(6):605-9.
El-Lamie, I. K., Shehata, N. A., Abou-Loz, S. K., & El-Lamie, K. I. (2000). Conservative surgical management of malignant ovarian germ cell tumors: the experience of the Gynecologic Oncology Unit at Ain Shams University. European Journal of Gynaecological Oncology, 21(6), 605-9.
El-Lamie IK, et al. Conservative Surgical Management of Malignant Ovarian Germ Cell Tumors: the Experience of the Gynecologic Oncology Unit at Ain Shams University. Eur J Gynaecol Oncol. 2000;21(6):605-9. PubMed PMID: 11214621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Conservative surgical management of malignant ovarian germ cell tumors: the experience of the Gynecologic Oncology Unit at Ain Shams University. AU - El-Lamie,I K, AU - Shehata,N A, AU - Abou-Loz,S K, AU - El-Lamie,K I, PY - 2001/2/24/pubmed PY - 2001/5/18/medline PY - 2001/2/24/entrez SP - 605 EP - 9 JF - European journal of gynaecological oncology JO - Eur. J. Gynaecol. Oncol. VL - 21 IS - 6 N2 - PURPOSE: To evaluate the role of extended surgical staging in patients with malignant ovarian germ cell tumors in the presence of cisplatinum-based combination chemotherapy. MATERIALS & METHODS: 16 patients aged between 13 and 40 years (mean 20.5) diagnosed and treated for malignant ovarian germ cell tumors at the Gynecologic Oncology Unit. Ain Shams University, during the period from May 1994 to October 1999. RESULTS: Six patients were diagnosed with dysgerminoma, six with immature teratoma and four with endodermal sinus tumor. Only seven cases were primarily managed at the unit and were subjected to proper surgical staging as required by FIGO (two in each of the stages IC, IIC and IIIA and one in stage IV). However, the remaining nine cases were referred to the unit, six after having unilateral salpingo-oophorectomy and no surgical staging, one patient after total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO), and one with recurrent dysgerminoma in the retroperitoneum and mediastinum following suboptimal treatment. None of these cases were surgically re-explored and all including the first six cases were given the standard BEP chemotherapy for 4-6 courses (mean 5.8). Follow-up ranged from 7-72 months (mean 30.5). All patients are alive without any evidence of disease recurrence except for one patient with a stage IIIA immature teratoma who had a local and distant recurrence and is undergoing second-line chemotherapy. All patients have their menstrual function preserved except for three patients; one having 46,XX pure gonadal dysgenesis with a preoperative FSH level of 120 U/l and the eldest two patients having a TAH+BSO as they had completed their families. Three patients are currently pregnant. CONCLUSION: In view of the high chemosensitivity and curability of ovarian germ cell tumors and their occurrence in young patients, every effort should be made to preserve one ovary and the uterus for future reproduction even in advanced cases. The role of revisional surgical staging, in particular retroperitoneal lymphadenectomy in light of these data and those of others should be redefined in the future. SN - 0392-2936 UR - https://www.unboundmedicine.com/medline/citation/11214621/Conservative_surgical_management_of_malignant_ovarian_germ_cell_tumors:_the_experience_of_the_Gynecologic_Oncology_Unit_at_Ain_Shams_University_ L2 - https://medlineplus.gov/ovariancancer.html DB - PRIME DP - Unbound Medicine ER -