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Oncological outcomes among young women with non-epithelial ovarian cancer: the YOC-Care study (Young Ovarian Cancer – Care)
  1. Lucas Minig1,
  2. Myriam Gracia Segovia2,
  3. Octavio Arencibia3,
  4. Cristina Zorrero4,
  5. Lola Marti5,
  6. Virginia García Pineda2,
  7. Juan Cespedes6,
  8. Isabel Niguez7,
  9. Blanca Gil-Ibanez8,
  10. Berta Diaz-Feijoo9,
  11. Soledad Fidalgo10,
  12. Irene Valencia11,
  13. Teodora Alonso-Gutierrez12,
  14. Lorena Gonzalez13,
  15. Amanda Veiga-Fernandez14,
  16. Enrique Chacon15,
  17. Isabel Negredo16,
  18. Leticia Azcona Sutil17,
  19. Mikel Gorostidi6 and
  20. Ignacio Zapardiel18
  21. On behalf of the YOC-Care Group Collaborative
  1. 1 Gynecologic Oncology Unit, IMED Hospitales, Valencia, Spain
  2. 2 Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
  3. 3 Gynecology Department, University Maternal Hospital Canary Islands, Las Palmas, Spain
  4. 4 Gynecology Department, CEU Cardenal Herrera University, Moncada, Comunitat Valenciana, Spain
  5. 5 Gynecological Oncology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
  6. 6 Gynecology Department, Hospital Universitario Donostia, San Sebastian, País Vasco, Spain
  7. 7 Gynecology Department, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
  8. 8 Gynecologic Oncology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
  9. 9 Gynecologic Oncology Unit, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
  10. 10 Gynecology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  11. 11 Gynecology Department, Hospital Universitario de Puerto Real, Puerto Real, Andalucía, Spain
  12. 12 Gynecology Department, Hospital Universitario de Burgos, Burgos, Castilla y León, Spain
  13. 13 Gynecology Department, Hospital Universitario de Torrejón, Torrejon de Ardoz, Madrid, Spain
  14. 14 Gynecology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  15. 15 Gynecologic Oncology, Universidad de Navarra, Pamplona, Navarra, Spain
  16. 16 Gynecology Department, Miguel Servet University Hospital, Zaragoza, Aragón, Spain
  17. 17 Gynecology Department, Hospital Universitario Virgen Macarena, Sevilla, Andalucía, Spain
  18. 18 Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
  1. Correspondence to Dr Lucas Minig, Gynecologic Oncology, Valencian Institute of Oncology (IVO), Valencia, Spain; miniglucas{at}


Objective To determine oncological outcomes and associated prognostic factors in women younger than 45 years diagnosed with non-epithelial ovarian cancer.

Methods A retrospective, multicenter Spanish study was performed including women with non-epithelial ovarian cancer younger than 45 years between January 2010 and December 2019. All types of treatments and stages at diagnosis with at least 12 months of follow-up were collected. Women with missing data, epithelial cancers, borderline or Krukenberg tumors, and benign histology, as well as patients with previous or concomitant cancer, were excluded.

Results A total of 150 patients were included in this study. The mean±SD age was 31.45±7.45 years. Histology subtypes were divided into germ cell (n=104, 69.3%), sex-cord (n=41, 27.3%), and other stromal tumors (n=5, 3.3%). Median follow-up time was 58.6 (range: 31.10–81.91) months. Nineteen (12.6%) patients presented with recurrent disease with a median time to recurrence of 19 (range: 6–76) months. Progression-free survival and overall survival did not significantly differ among histology subtypes (p=0.09 and 0.26, respectively) and International Federation of Gynecology and Obstetrics (FIGO) stage (I-II vs III-IV) with p=0.08 and p=0.67, respectively. Univariate analysis identified sex-cord histology with the lowest progression-free survival. Multivariate analysis showed that body mass index (BMI) (HR=1.01; 95% CI 1.00 to 1.01) and sex-cord histology (HR=3.6; 95% CI 1.17 to 10.9) remained important independent prognostic factors for progression-free survival. Independent prognostic factors for overall survival were BMI (HR=1.01; 95% CI 1.00 to 1.01) and residual disease (HR=7.16; 95% CI 1.39 to 36.97).

Conclusions Our study showed that BMI, residual disease, and sex-cord histology were prognostic factors associated with worse oncological outcomes in women younger than 45 years diagnosed with non-epithelial ovarian cancers. Even though the identification of prognostic factors is relevant to identify high-risk patients and guide adjuvant treatment, larger studies with international collaboration are essential to clarify oncological risk factors in this rare disease.

  • Granulosa Cell Tumor
  • Leydig Cell Tumor
  • Sertoli-Leydig Cell Tumor
  • Sex Cord-Gonadal Stromal Tumors

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors Conception or design of the work: IZ, MG, LM. Data collection: all authors. Data analysis and interpretation: IZ, MG, LM. Drafting the article: IZ, MG, LM. Critical revision of the article: all authors. Final approval of the version to be published: all authors. All authors contributed to the concept, design and writing of the manuscript, and are responsible for the overall content as guarantors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.