Clinical Retropective Analysis Of Malignant Ovarian Germ Cell Tumors

Objective: Malignant ovarian germ cell tumor, which always threat young female health, especially adolescent women, is one of malignant ovarian tumors. Patients' prognosis was bad ago even if they were carried out traditional radical surgery, at present, Patients' prognosis was not only improved significantly, but the ways of treatment altered fundamentally with application of effective comb -ined chemotherapy. In our study, by retropective analysis clinical information of patients with malignant ovarian germ cell tumors which visited in the first hospital of Jilin university 10 years recently, we want to learn of characteristic,treatment and prognosis or recurrence of the disease; by single-factor analysis, we also want to learn of influencing factors of recurrence.Methods: Collected 21 cases of malignant ovarian germ cell tumors from January in 1999 to March in 2009 in the first hospital of Jilin University, we want to learn of characteristic,treatment and prognosis or recurrence of the disease by analysis retrospectively clinical and follow-up information about the 21 patients, and apply Kaplan-Meier method to analyze influencing factors of recurrence such as patients' age,the place of tumor,the size of tumor,surgical method,pathological type,FIGO stage and chemotherapy and so on, and use Log-Rank method to analyze differences of recurrence rate, P<0.05 has statistical significance. Result: 1,The age of onset was 12-66 years, the mean age was (28.19±14.10) years and the median age was 26 years; patients less than 30 years were 14 cases, to occupy 66.67%; The majority of patients with MOGCT wereⅠstage(85.71%) and MOGCT almost was unilateral in the first surgery. 2,The patients with symptoms of abdominal pain were six cases(28.57%), acute abdominal pain were 3 cases in them;the patients with symptoms of abdominal distension were 2 cases(9.52%); the patients with symptoms of pelvic mass were 6 cases(28.57%); the patients with symptoms of abnormal vaginal bleeding and abnormal menstruation were 2 cases(9.52%); the patients with symptoms of emaciation and debilitation were 1 cases(4.76%); the remaining were four cases(19.05%). 3,The majority of Young patients were carried out reproductive operation, while The older,menopausal or peri-menopause were mainly carried out no reproductive operation. 4,Patients with postoperative chemotherapy accounted for 47.62%(10/21),while patients with no chemotherapy accounted for 52.38%(11/21); Pathological type of patients with no chemotherapy were mainly immature teratoma andⅠstage. 5,In 21 cases, the longest follow-up time has been 7 years and 6 months and the shortest has been 2 months;2 cases have been lost,and 3cases have been recurred; All of Relapsing patients were late clinical stage and no postoperative chemotherapy; 3 case of recurrence in patients survived so far after the second active treatment. 6,According to FIGO stage, we divided the object of study into early(Ⅰa ) and advanced (Ⅰc,ⅡandⅢ)groups and compared the recurrence rate of two groups, there was a significant difference (P=0.04<0.05); Compared no postoperative chemotherapy and with adjuvant chemotherapy groups, there was also a significant difference (P=0.04<0.05). 7,Recurrence of patients has not relationship with patients' age,the place of tumor,the size of tumor,surgical method,pathological type. 8,Except for 1 case with primary amenorrhea, two patients, who just menarche patients, occurred menstrual disorder and others patients did not change in menstruation.Conclusion: 1,Except for malignant teratoma, MOGCT occurred majority in young female; while malignant teratoma occurred majority in Peri-menopausal or postmenopausal women. 2,In our hospital, immature teratoma was mainly in the MOGCT;and almost all tumors not only involved in one side of ovarian but FIGO stage of majority tumors wasⅠstage when the first surgery. 3,The main symptoms of patients with MOGCT which visited are abdominal pain and pelvic mass followed by abdominal distension and vaginal bleeding. 4,In our hospital the treatment programs of patients with MOGCT accordanced with the current perspectives and effect was also good. 5,Overall prognosis of patients with MOGCT is good. Even if there is recurrence, patients may survive for a long time by the second positive treatment. 6,We think that recurrence of patients has not relationship with patients' age,the place of tumor,the size of tumor,surgical method,pathological type and has only relationship with FIGO stage and chemotherapy. 7,Ovarian function is not nearly impacted by chemotherapy drugs.