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Malign over germ hücreli tümörlerde klinikopatolojik özelliklerin prognoza etkisi

Yıl 2023, Cilt: 48 Sayı: 1, 54 - 63, 31.03.2023
https://doi.org/10.17826/cumj.1176706

Öz

Amaç: Malign over germ hücreli tümörleri, yumurtalık kanserlerinin %5'ine neden olur. Malign over germ hücreli tümörlerin nadir görülmesi nedeniyle prognoz ve sağkalım oranlarını inceleyen çalışmalar önemlidir. Çalışmamızda bu hastalarda sonuç ve prognostik faktörleri araştırmayı amaçladık.
Gereç ve Yöntem: Çalışma, Nisan 1992 ile Kasım 2017 tarihleri arasında kliniğimizde tedavi olmuş malign over germ hücreli tümör hastalarının klinikopatolojik kayıtlarını içermektedir. Demografik ve klinik özellikler, patolojik gözlemler, adjuvan tedavi modaliteleri ve takip detayları analiz edilerek sağkalıma etkileri araştırılmıştır.
Bulgular: Malign over germ hücreli tümörleri olan yüz onbeş hasta çalışmaya dahil edildi. Hastaların çoğu üreme çağındaki nullipar kadınlardı. Hastaların yaş ortalaması 27.5+14.3, ortalama takip süresi 71.04 ay idi. Araştırma 42 disgerminom, 37 immatür teratom, 17 miks germ hücreli tümör, 16 endodermal sinüs tümörü ve üç embriyonik karsinom olgusu içermektedir. Hastalık evresi sırasıyla hastaların %53'ünde %16.5, %25.2'sinde ve %5.2'sinde Evre 1, 2, 3 ve 4 idi.
Yetmişdokuz hastanın 55'ine fertilite koruyucu cerrahi uygulandı ve hastaların %34.5'inde gebelik elde edildi. Beş yıllık genel sağkalım %74 idi. Tümörlerin lokalizasyonu, optimal olmayan sitoredüksiyon, ileri evre hastalık, kötü farklılaşma, metastaz, mikst hücre histolojisi kötü prognostik faktörler olarak belirlendi. Çok değişkenli analizlerde hastalıksız sağkalımı etkileyen faktörler FIGO evresi, mikst germ hücre histolojisi ve suboptimal sitoredüksiyon olarak saptandı.
Sonuç: Malign over germ hücreli tümörlerin prognozu, özellikle genç, erken evre ve uygun şekilde ameliyat edilmiş hastalarda mükemmeldir. FIGO Evresi, mikst germ hücre histopatolojisi ve tam sitoredüksiyon, MOGCT'nin prognozunu etkileyen faktörlerdir. Üreme çağındaki tedavi gebelik sonuçlarını önemli ölçüde etkilemez. Bu nedenle, özellikle genç hastalarda koruyucu yaklaşım da iyi bir seçenek olarak düşünülmelidir.

Kaynakça

  • Brown J, Friedlander M, Backes FJ, Harter P, O'Connor DM, de la Motte Rouge T et al. Gynecologic Cancer Intergroup (GCIG) consensus review for ovarian germ cell tumors. Int J Gynecol Cancer. 2014;24:48-54.
  • Low JJ, Ilancheran A, Ng JS. Malignant ovarian germ-cell tumours. Best Pract Res Clin Obstet Gynaecol. 2012;26:347-55.
  • Turkmen O, Karalok A, Basaran D, Kimyon GC, Tasci T, Ureyen I et al. Fertility-sparing surgery should be the standard treatment in patients with malignant ovarian germ cell tumors. J Adolesc Young Adult Oncol. 2017;6:270-76.
  • Di Tucci C, Casorelli A, Morrocchi E, Palaia I, Muzii L, Panici PB. Fertility management for malignant ovarian germ cell tumors patients. Crit Rev Oncol Hematol. 2017;120:34-42.
  • Mangili G, Sigismondi C, Gadducci A, Cormio G, Scollo P, Tateo S et al. Outcome and risk factors for recurrence in malignant ovarian germ cell tumors: a MITO-9 retrospective study. Int J Gynecol Cancer. 2011;21:1414-21.
  • Vasta FM, Dellino M, Bergamini A, Gargano G, Paradiso A, Loizzi V et al. Reproductive outcomes and fertility preservation strategies in women with malignant ovarian germ cell tumors after fertility sparing surgery. Biomedicines. 2020;30:554.
  • Pectasides D, Pectasides E, Kassanos D. Germ cell tumors of the ovary. Cancer Treat Rev. 2008;34:427-41.
  • Ertas IE, Taskin S, Goklu R, Bilgin M, Goc G, Yildirim Y et al. Long-term oncological and reproductive outcomes of fertility-sparing cytoreductive surgery in females aged 25 years and younger with malignant ovarian germ cell tumors. J Obstet Gynaecol Res. 2014;40:797-805.
  • Boussios S, Attygalle A, Hazell S, Moschetta M, McLachlan J, Okines A et al. malignant ovarian germ cell tumors in postmenopausal patients: The royal marsden experience and literature review. Anticancer Res. 2015;35:6713-22.
  • Berek JS, Renz M, Kehoe S, Kumar L, Friedlander M. Cancer of the ovary, fallopian tube, and peritoneum: 2021 update. Int J Gynaecol Obstet. 2021;155:61-85.
  • Solheim O, Gershenson DM, Tropé CG, Rokkones E, Sun CC, Weedon-Fekjaer H et al. Prognostic factors in malignant ovarian germ cell tumours (The surveillance, epidemiology and end results experience 1978-2010). Eur J Cancer. 2014;50:1942-50.
  • Tangjitgamol S, Hanprasertpong J, Manusirivithaya S, Wootipoom V, Thavaramara T, Buhachat R. Malignant ovarian germ cell tumors: clinico-pathological presentation and survival outcomes. Acta Obstet Gynecol Scand. 2010;89:182-9.
  • Karalok A, Comert GK, Kilic C, Turkmen O, Kilic F, Basaran D et al. Cytoreductive surgery in advanced stage malignant ovarian germ cell tumors. J Gynecol Obstet Hum Reprod. 2019;48:461-66.
  • Liu Q, Ding X, Yang J, Cao D, Shen K, Lang J et al. The significance of comprehensive staging surgery in malignant ovarian germ cell tumors. Gynecol Oncol. 2013;131:551-4.
  • Lai CH, Chang TC, Hsueh S, Wu TI, Chao A, Chou HH et al. Outcome and prognostic factors in ovarian germ cell malignancies. Gynecol Oncol. 2005;96:784-91.
  • Murugaesu N, Schmid P, Dancey G, Agarwal R, Holden L, McNeish I et al. Malignant ovarian germ cell tumors: identification of novel prognostic markers and long-term outcome after multimodality treatment. J Clin Oncol. 2006;24:4862-6.
  • Hu T, Fang Y, Sun Q, Zhao H, Ma D, Zhu T et al. Clinical management of malignant ovarian germ cell tumors: A 26-year experience in a tertiary care institution. Surg Oncol. 2019;31:8-13.
  • Cicin I, Eralp Y, Saip P, Ayan I, Kebudi R, Iyibozkurt C et al. Malignant ovarian germ cell tumors: a single-institution experience. Am J Clin Oncol. 2009;32:191-6.
  • Billmire D, Vinocur C, Rescorla F, Cushing B, London W, Schlatter M et al. Children's Oncology Group (COG). Outcome and staging evaluation in malignant germ cell tumors of the ovary in children and adolescents: an intergroup study. J Pediatr Surg. 2004;39:424-9.
  • Gershenson DM. Management of ovarian germ cell tumors. J Clin Oncol. 2007;25:2938-43.
  • Chen J, Li Y, Wu J, Liu Y, Kang S. Whole-exome sequencing reveals potential germline and somatic mutations in 60 malignant ovarian germ cell tumors†. Biol Reprod. 2021;105:164-78.
  • Qin B, Xu W, Li Y. The impact of lymphadenectomy on prognosis and survival of clinically apparent early-stage malignant ovarian germ cell tumors. Jpn J Clin Oncol. 2020;50:282-87.
  • Lee KH, Lee IH, Kim BG, Nam JH, Kim WK, Kang SB et al. Clinicopathologic characteristics of malignant germ cell tumors in the ovaries of Korean women: a Korean Gynecologic Oncology Group Study. Int J Gynecol Cancer. 2009;19:84-7.
  • Low JJ, Perrin LC, Crandon AJ, Hacker NF. Conservative surgery to preserve ovarian function in patients with malignant ovarian germ cell tumors. A review of 74 cases. Cancer. 2000 ;89:391-8.
  • Tangir J, Zelterman D, Ma W, Schwartz PE. Reproductive function after conservative surgery and chemotherapy for malignant germ cell tumors of the ovary. Obstet Gynecol. 2003 ;101:251-7.
  • Zamani N, Rezaei PM, Ghasemian DS, Alizadeh S, Modares GM. Fertility sparing surgery in malignant ovarian Germ cell tumor (MOGCT): 15 years experiences. BMC Womens Health. 2021;21:282.
  • Topuz S, Iyibozkurt AC, Akhan SE, Keskin N, Yavuz E, Salihoglu Y et al. Malignant germ cell tumors of the ovary: a review of 41 cases and risk factors for recurrence. Eur J Gynaecol Oncol. 2008;29:635-7

The effect of clinicopathological features on prognosis in malignant ovarian germ cell tumors

Yıl 2023, Cilt: 48 Sayı: 1, 54 - 63, 31.03.2023
https://doi.org/10.17826/cumj.1176706

Öz

Purpose: Malignant ovarian germ cell tumors cause 5% of ovarian cancers. Studies examining prognosis and survival rates are significant due to malignant ovarian germ cell tumors' rarity. We aimed to investigate outcome and prognostic factors in these patients.
Materials and Methods: The study includes clinicopathological records of malignant ovarian germ cell tumor patients in our clinic between April 1992 and November 2017. Demographic and clinical characteristics, pathological observations, adjuvant treatment modalities, and follow-up details were analyzed, and their survival effects were investigated.
Results: One hundred fifteen patients with malignant ovarian germ cell tumors were analyzed. Most patients were reproductive-age nulliparous. The patients' mean age was 27.5+14.3, and the mean follow-up was 71.04 months. The research includes 42 dysgerminomas, 37 immature teratomas, 17 mixed germ-cell tumors, 16 endodermal sinus tumors, and three embryonic carcinomas. The disease stage was 1, 2, 3, and 4 in 53%, 16.5%, 25.2%, and 5.2% of patients, respectively.
Fertility-sparing surgery was conducted in 55 of 79 patients, and 34.5% received pregnancy. Five-year overall survival was 74%. Localization of tumors, non-optimal cytoreduction, advanced-stage disease, poor differentiation, metastasis, and mixed cell histology were determined as poor prognostic factors. In multivariate analyzes, factors affecting disease-free survival are the FIGO stage, mixed germ cell histology, and suboptimal cytoreduction.
Conclusion: The prognosis of malignant ovarian germ cell tumors is excellent, especially in young, early-stage, and adequately operated patients. FIGO Stage, mixed germ cell histopathology and complete cytoreduction affect the prognosis of MOGCT. Treatment at reproductive age does not significantly affect pregnancy outcomes. Therefore, the fertility sparring approach should be considered a good option, especially in young patients.

Kaynakça

  • Brown J, Friedlander M, Backes FJ, Harter P, O'Connor DM, de la Motte Rouge T et al. Gynecologic Cancer Intergroup (GCIG) consensus review for ovarian germ cell tumors. Int J Gynecol Cancer. 2014;24:48-54.
  • Low JJ, Ilancheran A, Ng JS. Malignant ovarian germ-cell tumours. Best Pract Res Clin Obstet Gynaecol. 2012;26:347-55.
  • Turkmen O, Karalok A, Basaran D, Kimyon GC, Tasci T, Ureyen I et al. Fertility-sparing surgery should be the standard treatment in patients with malignant ovarian germ cell tumors. J Adolesc Young Adult Oncol. 2017;6:270-76.
  • Di Tucci C, Casorelli A, Morrocchi E, Palaia I, Muzii L, Panici PB. Fertility management for malignant ovarian germ cell tumors patients. Crit Rev Oncol Hematol. 2017;120:34-42.
  • Mangili G, Sigismondi C, Gadducci A, Cormio G, Scollo P, Tateo S et al. Outcome and risk factors for recurrence in malignant ovarian germ cell tumors: a MITO-9 retrospective study. Int J Gynecol Cancer. 2011;21:1414-21.
  • Vasta FM, Dellino M, Bergamini A, Gargano G, Paradiso A, Loizzi V et al. Reproductive outcomes and fertility preservation strategies in women with malignant ovarian germ cell tumors after fertility sparing surgery. Biomedicines. 2020;30:554.
  • Pectasides D, Pectasides E, Kassanos D. Germ cell tumors of the ovary. Cancer Treat Rev. 2008;34:427-41.
  • Ertas IE, Taskin S, Goklu R, Bilgin M, Goc G, Yildirim Y et al. Long-term oncological and reproductive outcomes of fertility-sparing cytoreductive surgery in females aged 25 years and younger with malignant ovarian germ cell tumors. J Obstet Gynaecol Res. 2014;40:797-805.
  • Boussios S, Attygalle A, Hazell S, Moschetta M, McLachlan J, Okines A et al. malignant ovarian germ cell tumors in postmenopausal patients: The royal marsden experience and literature review. Anticancer Res. 2015;35:6713-22.
  • Berek JS, Renz M, Kehoe S, Kumar L, Friedlander M. Cancer of the ovary, fallopian tube, and peritoneum: 2021 update. Int J Gynaecol Obstet. 2021;155:61-85.
  • Solheim O, Gershenson DM, Tropé CG, Rokkones E, Sun CC, Weedon-Fekjaer H et al. Prognostic factors in malignant ovarian germ cell tumours (The surveillance, epidemiology and end results experience 1978-2010). Eur J Cancer. 2014;50:1942-50.
  • Tangjitgamol S, Hanprasertpong J, Manusirivithaya S, Wootipoom V, Thavaramara T, Buhachat R. Malignant ovarian germ cell tumors: clinico-pathological presentation and survival outcomes. Acta Obstet Gynecol Scand. 2010;89:182-9.
  • Karalok A, Comert GK, Kilic C, Turkmen O, Kilic F, Basaran D et al. Cytoreductive surgery in advanced stage malignant ovarian germ cell tumors. J Gynecol Obstet Hum Reprod. 2019;48:461-66.
  • Liu Q, Ding X, Yang J, Cao D, Shen K, Lang J et al. The significance of comprehensive staging surgery in malignant ovarian germ cell tumors. Gynecol Oncol. 2013;131:551-4.
  • Lai CH, Chang TC, Hsueh S, Wu TI, Chao A, Chou HH et al. Outcome and prognostic factors in ovarian germ cell malignancies. Gynecol Oncol. 2005;96:784-91.
  • Murugaesu N, Schmid P, Dancey G, Agarwal R, Holden L, McNeish I et al. Malignant ovarian germ cell tumors: identification of novel prognostic markers and long-term outcome after multimodality treatment. J Clin Oncol. 2006;24:4862-6.
  • Hu T, Fang Y, Sun Q, Zhao H, Ma D, Zhu T et al. Clinical management of malignant ovarian germ cell tumors: A 26-year experience in a tertiary care institution. Surg Oncol. 2019;31:8-13.
  • Cicin I, Eralp Y, Saip P, Ayan I, Kebudi R, Iyibozkurt C et al. Malignant ovarian germ cell tumors: a single-institution experience. Am J Clin Oncol. 2009;32:191-6.
  • Billmire D, Vinocur C, Rescorla F, Cushing B, London W, Schlatter M et al. Children's Oncology Group (COG). Outcome and staging evaluation in malignant germ cell tumors of the ovary in children and adolescents: an intergroup study. J Pediatr Surg. 2004;39:424-9.
  • Gershenson DM. Management of ovarian germ cell tumors. J Clin Oncol. 2007;25:2938-43.
  • Chen J, Li Y, Wu J, Liu Y, Kang S. Whole-exome sequencing reveals potential germline and somatic mutations in 60 malignant ovarian germ cell tumors†. Biol Reprod. 2021;105:164-78.
  • Qin B, Xu W, Li Y. The impact of lymphadenectomy on prognosis and survival of clinically apparent early-stage malignant ovarian germ cell tumors. Jpn J Clin Oncol. 2020;50:282-87.
  • Lee KH, Lee IH, Kim BG, Nam JH, Kim WK, Kang SB et al. Clinicopathologic characteristics of malignant germ cell tumors in the ovaries of Korean women: a Korean Gynecologic Oncology Group Study. Int J Gynecol Cancer. 2009;19:84-7.
  • Low JJ, Perrin LC, Crandon AJ, Hacker NF. Conservative surgery to preserve ovarian function in patients with malignant ovarian germ cell tumors. A review of 74 cases. Cancer. 2000 ;89:391-8.
  • Tangir J, Zelterman D, Ma W, Schwartz PE. Reproductive function after conservative surgery and chemotherapy for malignant germ cell tumors of the ovary. Obstet Gynecol. 2003 ;101:251-7.
  • Zamani N, Rezaei PM, Ghasemian DS, Alizadeh S, Modares GM. Fertility sparing surgery in malignant ovarian Germ cell tumor (MOGCT): 15 years experiences. BMC Womens Health. 2021;21:282.
  • Topuz S, Iyibozkurt AC, Akhan SE, Keskin N, Yavuz E, Salihoglu Y et al. Malignant germ cell tumors of the ovary: a review of 41 cases and risk factors for recurrence. Eur J Gynaecol Oncol. 2008;29:635-7
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma
Yazarlar

Yegana Seyidova 0000-0002-3286-6453

Sevtap Seyfettinoğlu 0000-0001-8607-6628

Ümran Küçükgöz Güleç 0000-0003-3094-1381

Ghanim Khatib 0000-0002-0163-1141

Ahmet Barış Güzel 0000-0002-9498-7592

Derya Gümürdülü 0000-0002-7129-3424

Semra Paydaş 0000-0003-4642-3693

Mehmet Ali Vardar 0000-0003-0616-6733

Yayımlanma Tarihi 31 Mart 2023
Kabul Tarihi 3 Ocak 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 48 Sayı: 1

Kaynak Göster

MLA Seyidova, Yegana vd. “The Effect of Clinicopathological Features on Prognosis in Malignant Ovarian Germ Cell Tumors”. Cukurova Medical Journal, c. 48, sy. 1, 2023, ss. 54-63, doi:10.17826/cumj.1176706.