Abstract
To review ovarian cancer cases in children and adolescents in Siriraj Hospital and assess the prognosis, recurrence of disease, and reproductive outcomes after treatment. A retrospective descriptive study was conducted in ovarian cancer patients 21 years and younger who had been treated at Siriraj Hospital between January 1990 and December 2009. Medical records were reviewed and relevant data were recorded. A total of 48 cases met the criteria; their mean age was 16.4 years. Abdominal distension was the major symptom. 91.6% were germ cell tumors and the remaining cases were sex cord-stromal and epithelial tumors. More than half (25/48 cases) presented with stage I disease. The most common used chemotherapy regimen for germ cell tumors was BEP (bloemycin, etoposide, cisplatin). Most of patients had favorable outcomes; 46/48 cases had complete remission and retained their good health at the time of the review. We had only one recurrent case and one dead case. Ten of contacted patients had married and 3 of them had successful full-term pregnancies. Ovarian malignancy in children and adolescents is a rare disease. The authors reported 48 cases in 20 year-period of work. Most of them have favorable outcomes. Return of ovarian function and fertility are the topics of interest.
Highlights
Ovarian cancer is the most aggressive disease in female reproductive organs and two third of these patients presented in the advanced stages due to non-specific presenting symptoms and lack of effective screening methods
Materials and Methods: A retrospective descriptive study was conducted in ovarian cancer patients 21 years and younger who had been treated at Siriraj Hospital between January 1990 and December 2009
The common ovarian cancer histology differed from the older group; the majorities were germ cell tumors and sex cordstromal tumors
Summary
Ovarian cancer is the most aggressive disease in female reproductive organs and two third of these patients presented in the advanced stages due to non-specific presenting symptoms and lack of effective screening methods. Ovarian cancer which occurs commonly in women more than 50 years old is the epithelial histological cell type. Standard treatment for these patients includes laparotomy for total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH, BSO) and comprehensive surgical staging; follow by adjuvant combination platinum-based chemotherapy, dependent on their stages. The incidence of ovarian cancer in these groups were 0.102 and 1.072 per 100,000 female populations per year in children less than 9 years old and girls between 10-19 years old, respectively (Brookfield et al, 2009). The recommended treatments in this group are conservative surgery with comprehensive staging to rule out occult diseases, following by adjuvant combination chemotherapy regimens which depended on histology and stages
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