Abstract

BackgroundMOGCT is rare tumors and represent 2% of all tumors of the ovary. Fertility preserving surgery is the standard of care for pts with MOGCT. Comprehensive surgical staging involves unilateral adnexectomy, omentectomy, peritoneal biopsies, washings and lymph node sampling. Visual inspection has been suggested as an alternative. Proposed surgical approach includes complete resection of the tumor-containing ovary with sparing of fallopian tube, inspection and palpation of contralateral ovary, omentum, lymph nodes, and peritoneum, biopsy of any suspicious lesions or lymph nodes, and collection of peritoneal washing or ascites. The objective of the study was to describe the clinico-pathologic features and treatment outcome of all patients diagnosed with MOGCT at the largest Russian Research Cancer Center. MethodsA total of 149 pts treated for MOGCT in our center between 1987-2018 were included into this retrospective study. All data including clinical symptoms, demographics, stage, surgery, chemotherapy, survival and fertility function were analyzed and assessed in univariate and multivariate analysis. The median age was 22 years (range, 12-49 years). 109 (73.2%) of 149 underwent fertility-sparing surgery followed by chemotherapy (ChT). Histologically 29.5% (n = 44) of cases were pure dysgerminoma. All pts received BEP/EP regimens as a first line treatment. 14 (9.4%) pts had gonadal dysgenesis. ResultsWith median follow-up of 86 mo. (range 1-337 mo.) 5-year OS was 92%. The 5-year disease free survival (DFS) was 87% (9.4% pts relapsed). The 5-year DFS in pts with dysgerminoma and non-dysgerminoma was 98% and 91% respectively (p = 0,2). The 5-year OS in pts with stage I was 100% and stages II-IV was 91%. Complete response reached in 97 (67.3%) of 144 assessed pts, marker-negative partial response registered in 34 (23.6%) pts. After first-line ChT completion 34/144 (23.6%) pts underwent surgical resection of residual masses. ConclusionsThe BEP regimen is a standard of care and provides high cure rate. Fertility-sparing surgery is standart volume of surgery even in advanced stages of disease. The BEP regimen does NOT adversely affect on fertility function of pts. Legal entity responsible for the studyThe authors. FundingHas not received any funding.All authors have declared no conflicts of interest.

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