| Objective: To investigate the clinicopathologic characteristics of Malignant Ovarian Germ Cell Tumor ( MOGCT ) , investigate the clinicopathologic characteristics of MOGCT in psetmenopause, analyze the effects on endocrine and reproductive function of fertility-preserving treatmenrt for MOGCT. Methods: In this study, clinicopathological characteristics and follow-up data of 50 cases with MOGCT from January, 1987 to October, 2004 in the general hospital of gynecology and obstetrics were investigated, as group A, 424 cases with mature teratoma during the same period as control group (group B ), investigate clinicopathologic characteristics of the both groups, analyze the related factors affected the survival rate of MOGCT; the fertility-preserving surgery was performed in 22 patients, 17 cases among them were alive ( group C ) , and 35 cases selected with random accepted unilateral salpingo-oophorectomy with mature teratomas during the same period in the same hospital ( group D ), comparison with follow-up information regarding menstruation and reproductive function of the two groups. Result:1 The percentage of MOGCT was 9.35 % of all the patients with malignant ovarian tumor during the same period in the general hospital, the most common type of MOGCT was dysgerminoma and yolk sac tumor;2 Mean age at time of diagnosis of MOGCT and mature teratoma were 29.96 ±16.95 and 36.58 ±13.50 years old respectively, mean age at time of diagnosis was younger in group A than that in group B (P < 0.001) . No differences were shown between the two groups in the median age of menarche, marriage and the number of pregnancy and delivery. The mean age at time of diagnosis in teratomas with malignant change was older the others;3 Symptom and course: the most common symptom of MOGCT were lower abdominal pain and abdominopelvic masses, the most common symptom of mature teratoma was detected the tumor in a physical examination; 80 percent of group A has a history less than 2 months since presenting symptom, the course of group A was shorter than group B ( P < 0.001 );4 Menstrual history: 8 patients were postmenopausal, the percentage of postmenopause vaginal hemorrhage before episode was 12.50% ( 1/8 ); the percentage of abnormal menstrual pattern was 20.51 % ( 8/39 ), 9 patients(18.00% ) had abnormal vaginal hemorrhage before episode; 3 of 22 patients after conservative therapy had abnormal menstrual pattern during chemotherapy; all the patients went into regular menses at the time before therapty within 3 months after adjuvant chemotheray;5 Behavior of MOGCT in postmenopause: the symptom of MOGCT was similar in postmenopause and premenopause, differences were shown between MOGCT and mature teratoma in postmenopause; teratoma with malignant change was more in postmenopause than in premenopause; stage of MOGCT was later in postmenopause than that in premenopause, survival rate of MOGCT was less in postmenopause than that in premenopause, but both had no statistics significance;6 Surgery history: 22 patients received conservative surgery, 21 patients received extensive surgery,and 7 patients received resect segment tion;there was no statistics significance in survival rate of conservative surgery and extensive surgery, survival rate of conservative surgery and extensive surgery were better than that in resect segment tion;7 Assistant therapy after surgery: 42 patients received Assistant therapy after surgery: 39 patients received chemotherapy, VAC used in 30 cases^ PVB used in 6 cases ^ BEP in 2 cases and thiotepa in 1 case; radiotherapy used in...
|
PDF Full Text Request