Survival and reproductive outcomes after fertility-sparing surgery and postoperative adjuvant chemotherapy in malignant ovarian germ cell tumors

ABSTRACT

Objective. Ovarian germ cell tumors are uncommon tumors with an excellent prognosis. Our aim in this study is to retrospectively examine the reproductive and survival results of ovarian malignant  germ cell tumors (OMGCTs) following fertility-preserving surgical intervention and postoperative chemotherapy.
Patients and Methods. Demographic, clinical and outcome data of  twenty-two OMGCT patients managed during the period from January 2012 to December 2016 were gathered and analyzed.
Results. The patients’ median age was 25 years at the time of diagnosis. Dysgerminoma represented 40.9% of cases and ten patients had stage I disease. Unilateral salpingo-oophorectomy  with preservation of the contra-lateral ovary and the uterus was the standard surgical procedure. The median number of chemotherapy courses was three courses. The median follow-up was 48 months. The overall five-year survival rate was 100%, while the disease-free five-year survival rate was 90%. Thirteen patients (59%) reported regular menstrual cycles. Fifteen patients (68.2%) wished to conceive, 10 (66.7%) became pregnant naturally and 8 (53.3%) gave birth to living children.
Conclusions. Survival and reproductive results following fertility-preserving  surgery and adjuvant chemotherapy in OMGCTs are satisfactory, although counseling and education are still required.