Clinical Analysis Of Malignant Ovarian Germ Cell Tumors In36Cases

Objective:To evaluate the clinical features,treatment,prognosis,factorsaffecting recurrence of the Malignant Ovarian Germ Cell Tumor.Methods:We collected36cases of gynecological inpatients with theMalignant Ovarian Germ Cell Tumors in the First Hospital of Jilin University during January2002to October2012.Through retrospectively reviewing the clinical data of all the patients,the study compared the age,staging,histologic types,types of surgery,chemotherapy to the prognosis.Results:Thirty-six patients with MOGCT,younger than thirty-years oldand thirty-years old accounted for83.3%and more than thirty years-oldaccounted for16.67%.The median age was twenty-three year(range:7-64years).The main clinical symptom are as follows:the patients accidentally touched pelvic mass by27.78%(10/36);abdominal pain by27.78%(10/36),including six cases of acute abdominal pain (2cases of tumor torsion and4cases of ovarian capsule rupture);abdominal distension by11.11%(4/36);vaginal bleeding by8.33%(3/36);fevering by8.33%(3/36).The histological types were4cases of dysgerminoma,15cases of immature teratoma,1cases of primary ovarian choriocarcinoma,11cases of yolk sac tumor,1cases of mixed malignant germ cell tumors (including components of seminoma,embryonal carcinoma,villus epithelial carcinoma),1cases of embryonal carcinoma,3cases of malignant tumor arising from the maturity teratoma.According to the International Federation of Gynecology and Obstetrics(FIGO)77.78%of patients presented with stage I disease;11.11%,stage II;5.56%,stage III;5.56%,uncertain stage,similarly to the those reported literations.With the application of effective chemotherapy drugs,conservative f ertility-sparing surgery combined and the necessary postoperative adjuvantplatinum-based combination chemotherapy is the main treatment for the young women with malignant ovarian germ cell tumors.In thirty-six patients,the fertility-sparing surgery was performed in the twenty-eight patients;eight cases with no fertility requirements of patients underwent radical operation.The conservative operation group(fertility-sparing surgery group)VSradical surgery group(non-fertility preservation group)was found to be nosignificantly correlation with the prognosis of MOGCT.After a median follow-up of33months(range3-136months),there were six cases relapsed(13.9%),with one patient dying of the disease;others five relapsed patientswho underwent successfully salvaged treatment were alive to the end ofthe follow-up.Clinical-pathologic staging(p=0.007<0.05),histologic types(p=0.005<0.05),the standard chemotherapy(p=0.049<0.05)were main factors affecting prognosis of MOGCT.Conclusion: The malignant germ cell tumors mainly present in the younggirls and young women,so the treatment emphasizes individuality andhumanization.The fertility-sparing surgery and postoperative adjuvantchemotherapy is considered to be the most appropriate treatment for the youngwomen of MOGCT.The older women and young women who had given birthcan be performed radical surgery.In addition,the postoperative adjuvantplatinum-based combination chemotherapy plays an important role in thetreatment of MOGCT.