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2022-RA-1433-ESGO Reproductive outcomes after conservative treatment in malignant ovarian germ cell tumors (MOGCTs) patients: a MITO-9 study
  1. Alice Bergamini1,
  2. Francesca Vasta2,
  3. Luca Bocciolone3,
  4. Giovanna Scarfone4,
  5. Chiara Cassani5,
  6. Gabriella Ferrandina6,
  7. Rocco de Vivo7,
  8. Saverio Danese8,
  9. Marianna Di Filippo1,
  10. Elisa Grassi1,
  11. Gennaro Cormio9,
  12. Sandro Pignata10 and
  13. Giorgia Mangili11
  1. 1Obstetrics and Gynecology, Università Vita- Salute San Raffaele; IRCCS Ospedale San Raffaele, MILANO, Italy
  2. 2Università Vita- Salute San Raffaele, MILANO, Italy
  3. 3Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy
  4. 4Department of Obstetrics, Gynecology and Neonatology, University of Milan, Ospedale Maggiore Policlinico, Milano, Italy
  5. 5Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
  6. 6UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubb, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
  7. 7AULSS 8 Berica, Oncology Unit, Vicenza, Italy
  8. 8Obstetrics and Gynecology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
  9. 9Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
  10. 10Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Napoli, Naples, Italy., Napoli, Italy
  11. 11Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, MILANO, Italy


Introduction/Background Malignant ovarian germ cell tumours (MOGCTs) are rare tumours mainly affecting women in reproductive age, hence fertility preservation is of paramount importance. The mainstay of treatment is fertility sparing surgery (FSS) followed by active surveillance in selected cases or multidrug BEP (bleomycin, cisplatin, etoposide) chemotherapy. Evidence available on fertility following treatment of MOGCTs is scanty.The aim of this study is to evaluate the reproductive outcomes of patients treated with FSS for MOGCTs in MITO centres (Multicentre Italian trials in gynecologic oncology).

Methodology All the included patients were treated conservatively, both in primary surgery and for relapse. The indication on adjuvant chemotherapy in stage I disease varies among centres. Patients were sent a questionnaire evaluating their desire of conception, fertility and endocrine outcomes. Data were analyzed with descriptive statistics. Univariate and multivariate analyses were used to assess correlation between fertility outcomes and clinicopathological variables.

Results 164 patients were sent the questionnaire, that was completed by 114 patients (69.5%). Among all patients, 38 (33.3%) expressed a desire for pregnancy, 29 (76.3%) of which successfully conceived. 62.1% patients who conceived received adjuvant chemotherapy. 97,7% conceptions occurred spontaneously. Six patients entered menopause after treatment (5.3%), 5 of whom received chemotherapy. No statistically significant difference was detected in terms of fertility outcomes between patients receiving adjuvant chemotherapy and those addressed to surveillance. When analysing factors affecting the pregnancy rate, the desire of conception was the only statistically significant factor.

Conclusion The results of the present study suggest that fertility outcomes in MOGCTs patients despite surgery and chemotherapy are very promising. The only factor significantly affecting the pregnancy rate after a MOGCTs diagnosis is the desire of conception.

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