Article Text
PDF
Abstract
Introduction To compare the survival outcomes between surveillance and adjuvant chemotherapy in patients with stage I ovarian immature teratomas (IMTs) who underwent fertility-sparing surgery.
Methods In this retrospective cohort analysis, patients with stage IA Grade 2–3, stage IB and stage IC ovarian IMTs between 2011 to 2023 from PUMCH Rare Cancer Registry were identified. A shared decision about surveillance or chemotherapy was made by physician and patients or their guardians.
Results A total of 103 patients were included. As the largest tertiary referral center of gynecologic germ cell tumor in China, 75 patients (72.8%) underwent surgery in local hospitals from 21 different provinces referred to us for further treatment. Forty patients chose surveillance after surgery. The median age at diagnosis was 19 years old (range 3–37). After a mean follow-up period of 29.9 months, only one patient with stage IA grade 2 IMT who underwent cystectomy had recurrence in the same ovary. The menstruation was not affected in all patients of reproductive age. Successful pregnancy was achieved in four patients without adverse events. In chemotherapy group, 63 patients received cisplatin-based adjuvant chemotherapy. Patient age, tumor stage and grade were similar in two groups. There was no statistical difference of 3-year disease free survival (DFS) and overall survival (OS) between two groups (Log Rank p=0.325 and 0.304).
Conclusion/Implications We did not observe survival differences in recurrence between patients with stage I ovarian IMTs who underwent adjuvant chemotherapy or not. Surveillance may be safe and preferable in early stage IMT patients who underwent complete resection of tumor.
DFS of patients of surveillance vs chemotherapy group
OS of patients of surveillance vs chemotherapy group