8-year Analysis of the Prevalence of Lymph Nodes Metastasis, Oncologic and Pregnancy Outcomes in Apparent Early-Stage Malignant Ovarian Germ Cell Tumors

Purpose: To determine the rate of lymph node metastasis, oncologic and pregnancy outcomes in apparentearly-stage malignant ovarian germ cell tumor (MOGCT). Materials and
Methods: Medical records of apparentearly-stage MOGCT patients undergoing primary surgical treatment at Siriraj Hospital, Bangkok, Thailand,between January 2006 and December 2013, were retrospectively reviewed.
Results: Thirty-eight patients hadapparent stage I-II MOGCT. The mean age was 22.1±7.7 years (median, 20.8 years; range, 7.7-35.6 years). Themean tumor size was 17.8±6.5 cm with a median of 20 (range 4-30) cm. Three most common histopathologieswere dysgerminoma (12 patients, 31.6%), immature teratoma (12 patients, 31.6%), and endodermal sinus tumor(6 patients, 15.8%). Twenty-seven of 38 patients underwent lymphadenectomy; 13 patients (48.2%) were stageIA and 8 patients (29.6%) were stage IC. The rate of retroperitoneal nodes metastasis was 7.4% (2/27 patients).At 26.1 months of median follow-up time (range 1.9-88.5 months), 9 patients retained fertility functions, withuneventful pregnancies in 3 of these. Only one patient (2.6%) had progression of disease at 4.9 months aftersurgery. The 5-year survival rate was 97.4%.
Conclusion: As the rate of pelvic or para-aortic node metastasisin MOGCT is considerable, lymphadenectomy should be incorporated in surgical staging procedures.