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Pure Immature Teratoma of the Ovary in Adults: Thirty-Year Experience of a Single
Tertiary Care Center
#MMPMID26332392
Alwazzan AB
; Popowich S
; Dean E
; Robinson C
; Lotocki R
; Altman AD
Int J Gynecol Cancer
2015[Nov]; 25
(9
): 1616-22
PMID26332392
show ga
OBJECTIVE: The aim of this study was to evaluate clinicopathologic
characteristics, treatment outcome, and reproductive function in women diagnosed
with ovarian immature teratoma (IT). Our standard chemotherapy regime is
currently etoposide/cisplatin (EP), creating a unique opportunity to evaluate
this protocol in ovarian ITs. MATERIALS AND METHODS: This study is a
retrospective analysis. Twenty-seven women older than 18 years with ovarian IT
stages IA to IIIC were identified and included in this study. Patients were
treated at 1 institution, Health Sciences Center, Women's Hospital, Winnipeg,
Manitoba, Canada, between 1983 and 2013. RESULTS: The median age at diagnosis was
27.0 years (range, 18-36 years). Twenty-two (82%) presented with an International
Federation of Gynecology and Obstetrics stage I disease, 3 (11%) had stage II,
and 2 patients (7%) had stage III disease. The histologic grade distribution was
grade I in 9 patients (33%), grade II in 3 patients (11%), and grade III in 15
patients (56%). Initial management was surgical for all patients: 3 (11%)
hysterectomy and bilateral salpingo-oophorectomy, 1 (4%) cystectomy only, and 23
(85%) unilateral salpingo-oophorectomy. Twenty-one patients (78%) received
adjuvant therapy. The median follow-up was 60 months (range, 36-72 months). One
patient recurred (histological grade III) 6 months after surgery and had a
complete clinical response to 4 cycles of EP chemotherapy. Twelve patients
reported an attempt to conceive resulting in 10 pregnancies (8 after
chemotherapy). CONCLUSIONS: Ovarian IT is a curable disease. Fertility-sparing
surgery should be offered. Adjuvant treatment with cisplatinum-based
chemotherapy, typically with bleomycin, etoposide, and cisplatin, is still
considered the standard in stages greater than stage IA grade I.
Etoposide/cisplatin as a primary chemotherapy regime for early- or advanced-stage
disease is an effective treatment with minimal adverse effects and high
tolerability. This is the first published study examining EP as a primary
treatment modality for IT. Further studies are needed to strengthen these
findings.
|Adolescent
[MESH]
|Adult
[MESH]
|Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
[MESH]
free
free
free
