Non-Epithelial Ovarian Cancer; NCI Study

Abstract

Background: Non-epithelial cancers of the ovary are uncommon. They include malignancies of germ cell origin, sex cord-stromal cell origin, metastatic carcinomas to the ovary, and a variety of extremely rare ovarian cancers, such as sarcomas and lipoid cell tumors. Nonepithelial malignancies account for about 10% of all ovarian cancers. Objective: To review the management of Non-epithelial ovarian cancer in the NCI Cairo university during a period of 5 years (2005 till 2010). Material and Methods: Retrospective study including 114 patients who were diagnosed and treated with Non-epithelial ovarian cancer (2005 to 2010). Data were collected from the biostatistics and cancer epidemiology department. Results: Out of 114 patients; 25(21.9%) were benign and 25 (21.9%) were borderline malignant; 55 (48.2%) were malignant and 9 (7.89%) of them were unpredicted biologic behavior; the median age of the study population was 49.7 years (range 14_83years). Panhysterectomy was done in 77(67.5%) of the patients; ovariectomy and debulking were done in 22(19.3%; salpingooophorectomy was done in 10(8.8%) 0f patients and cystectomy was done in 3(2.6%) and 2 cases underwent biopsy. Conclusion: Sex cord-stromal tumors and malignant germ cell tumors are the most common nonepithelial ovarian cancers. These tumors often, but not always, present with the sequelae of overproduction of either androgens or estrogens. It is important to diagnose these masses early, as overall prognosis is typically very good for early stage disease in all histological subtypes. Both sex cord-stromal tumors and malignant germ cell tumors of the ovary are treated with initial surgical resection. Fertility sparing surgery can be considered for both sex cord-stromal and malignant germ cell tumors of the ovary. Depending on the pathological diagnosis and disease stage, postoperative management consists of either expectant management or adjuvant chemotherapy. It is recommended that all patients with nonepithelial ovarian cancer be monitored for evidence of disease recurrence on a standardized schedule.