Management of Bilateral Malignant Ovarian Germ Cell Tumors: A MITO-9 Retrospective Study. Issue 2 (1st February 2015)

• Record Type: Journal Article
• Authors: Mangili, Giorgia; Sigismondi, Cristina; Scollo, Paolo; Ferrandina, Gabriella; Candiani, Massimo; Angioli, Roberto; Viganò, Riccardo; Scarfone, Giovanna
• Is Part Of: International journal of gynecological cancer. Volume 25:Issue 2(2015:Feb.)
• Page Start: 203
• Page End: 207
• Publication Date: 2015-02-01
• Subjects: Malignant ovarian germ cell tumors -- Bilaterality -- Fertility-sparing surgery -- PEB chemotherapy; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000358
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: Bilaterality is rare in malignant ovarian germ cell tumors (MOGTs). The bilateral ovarian involvement represents a critical issue when diagnosed in young women desiring to preserve fertility. The aim of this study was to evaluate clinical characteristic and management of patients bilateral MOGTs. Methods: Patients affected by bilateral MOGT and treated at MITO group centers were reviewed. Results: In 145 patients with MOGTs, 5.5% were bilateral. Three patients were affected by dysgerminoma (associated with bilateral gonadoblastoma in 1), 2 by immature teratoma, 2 by mixed germ cell tumors, and 1 by embryonal carcinoma. International Federation of Gynecology and Obstetrics stage was 3 IB, 1 IC, 3 IIIC, and 1 IV. Three patients received radical surgery, and the patient with dysgerminoma associated with gonadoblastoma received bilateral adnexectomy. Four patients received fertility-sparing surgery; 2 patients received unilateral salpingo-oophorectomy and contralateral cystectomy; in 2 patients, the ovaries were completely transformed in neoplastic tissue; suspecting a contralateral dysgerminoma histology, a unilateral salpingo-oophorectomy and contralateral biopsy were performed, and the contralateral neoplastic ovary was left unresected. Six patients received adjuvant chemotherapy. Seven patients are disease free after a median follow-up of 54 months. The patient affected by embryonal carcinoma died of disease. Two patients resumed menstruation, and one had a pregnancy. A compromised ovarian function was found in 2 patients, and they were addressed to oocyte cryopreservation. Conclusions: Bilateral MOGTs have a good prognosis. In dysgerminoma histology, residual disease could be left to spare fertility. An oncological and reproductive function follow-up is recommended.