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Fertility pregnancy
786 Fertility-sparing and minimally invasive surgery in patients with stage I malignant ovarian germ cell tumours in Germany
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  1. M Klar1,
  2. H Plett2,
  3. P Harter2,
  4. F Heitz2;3,
  5. S Kommoss4,
  6. J Keul5,
  7. E Roser3,
  8. J Sehouli3,
  9. E Ioana Braicu3,
  10. M Bossart1,
  11. MF Hasanov1,
  12. B Czogalla6,
  13. A Burges6,
  14. T Link7,
  15. M Doris8,
  16. A Staebler9,
  17. L Hanker10 and
  18. A Hasenburg11
  1. 1University of Freiburg, Freiburg Medical School, Department of Obstetrics and Gynaecology, Freiburg, Germany
  2. 2Evang. Huyssens-Stiftung Essen-Huttrop (eine Einrichtung der KEM | Evang. Kliniken Essen-Mitte gGmbH), Essen, Germany
  3. 3Charité – Universitätsmedizin Berlin, Department of Gynecology with Center for Oncological Surgery, Berlin, Germany
  4. 4Tübingen University hospital , Department of Women’s health, Tuebingen, Germany
  5. 5Tübingen University Hospital, Obstetrics and Gynaecology, Tübingen, Germany
  6. 6University Hospital LMU Munich Grosshardern, Obstetrics and Gynaecology , Germany
  7. 7University Hospital of Dresden, Obstetrics and Gynaecology, Dresden, Germany
  8. 8University Hospital of Munich, Institute of Pathology, Munich, Germany
  9. 9University Hospital of Tuebingen, Institute of Pathology, Tuebingen, Germany
  10. 10University Hospital Schleswig-Holstein, Obstetrics and Gynaecology , Luebeck, Germany
  11. 11University of Mainz, Obstetrics and Gynaecology, Mainz, Germany

Abstract

Introduction/Background*Malignant ovarian germ cell tumours (OGCT) often affect women of younger age at an early stage of disease who may desire fertility conservation. The Arbeitsgemeinschaft fuer Gynaekologische Onkologie (AGO) has established a clinicopathological (Current Ovarian geRm cell and SEx cord stromal Tumour Treatment strategies, CORSETT) database to describe treatment strategies and outcomes for these women.

Methodology 20 German centres entered mixed retro- and prospective data of 56 FIGO stage I OGCT patients treated between 2000 to 2014 into the CORSETT database. An independent CORSETT pathology reference panel re-evaluated the primary histological diagnosis. A descriptive analysis of the treatment strategies, pregnancy rates and disease recurrence was conducted.

Result(s)*Median age at diagnosis of patients with malignant dysgerminoma, mixed OGCT and teratoma was 28 (IQR 26 – 33), 33 (30 – 40) and 38 (29 – 44) years. FIGO IA/IB/IC stage distribution was 13/2/11 for dysgerminoma, 3/0/9 for mixed OGCT and 8/0/8 for teratoma patients. Laparoscopy was performed for 23 (69.7%) dysgerminoma, six (35.3%) mixed OGCT and eight (40%) teratoma patients and fertility-sparing surgery was provided for > 80% of all FIGO I OGCT patients. Intra-operative cyst rupture occurred in six (19.4%) dysgerminoma, five (41.6%) mixed OGCT and four (25.5%) teratoma patients and adjuvant chemotherapy was consequently given in one (3.5%) dysgerminoma, nine (81.2%) mixed OGCT and eight (47%) teratoma patients. Four (14.3%) dysgerminoma, three (27. 3%) mixed OGCT and four (23.5%) teratoma patients conceived after first line treatment. The disease reoccurred in two (7.1%) dysgerminoma, five (45.5%) mixed OGCT and two (11.8%) teratoma patients, predominantly intraperitoneally. No FIGO I OGCT patient died due to disease recurrence.

Conclusion*Women with mixed OGCTs had a high risk of intra-operative cyst rupture and high recurrence rates despite FIFO stage I disease. These events had no impact though on overall survival rates.

https://doi.org/10.1136/ijgc-2021-ESGO.245

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