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Original research
Fertility outcomes in stage I ovarian immature teratomas
  1. Giuseppe Marino1,
  2. Tommaso Grassi2,
  3. Elena De Ponti3,
  4. Filippo Testa1,
  5. Serena Negri1,
  6. Daniela Giuliani2,
  7. Marta Seca1,
  8. Martina Bombelli1,
  9. Alice Santagati1,
  10. Martina Bertoni1,
  11. Marta Jaconi4,
  12. Cristina Maria Bonazzi2,
  13. Andrea Alberto Lissoni2,
  14. Fabio Landoni1,2 and
  15. Robert Fruscio1,2
    1. 1 Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
    2. 2 UO Gynecology, Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza, Italy
    3. 3 Department of Physical Medicine, Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza, Italy
    4. 4 Department of Pathology, Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza, Italy
    1. Correspondence to Professor Robert Fruscio, Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy; robert.fruscio{at}unimib.it

    Abstract

    Objective To evaluate the impact of adjuvant chemotherapy, type of ovarian surgery, and the surgical approach on fertility in patients with stage I immature teratoma of the ovary.

    Methods Clinicopathologic data were retrospectively collected and analyzed from a cohort of 47 patients with childbearing desire treated for a stage I immature teratoma of the ovary at IRCCS San Gerardo dei Tintori Hospital, Monza, Italy. Multivariate logistic regression was used to address the influence of chemotherapy and type of surgery on the outcome.

    Results Among the patients included, 78.7% (37/47) were able to get pregnant, with a live birth rate of 80.9% (51/63 pregnancies). These rates were not different between adjuvant chemotherapy versus surveillance group (62.5% (5/8) and 82.0% (32/39), respectively; p=0.22) nor between the type of ovarian surgery (cystectomy vs unilateral salpingo-oophorectomy; p=0.57) and surgical approach (laparotomy or laparoscopy; p=0.18). A statistically significant difference was found for stage of disease (a decrease in pregnancy rate from 86.5% (32/37) for stage IA to 50.0% for stage IC (5/10); p=0.02), but it was not confirmed in the multivariate analysis. After relapse diagnosis and management, a total of 62.5% (5/8) of patients conceived and had at least one live birth baby.

    Conclusions The fertility-sparing approach is feasible in this population, and fertility does not depend on surgical approach or post-operative treatment. However, adjuvant chemotherapy should be carefully evaluated in this setting.

    • Adnexal Diseases
    • Ovarian Neoplasms
    • Surgical Oncology

    Data availability statement

    Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. In accordance with the Journal’s guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested.

    https://doi.org/10.1136/ijgc-2024-005534

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      Data availability statement

      Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. In accordance with the Journal’s guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested.

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      Footnotes

      • X @TommasoGrassi3

      • GM and TG contributed equally.

      • Contributors GM: conceptualization, methodology, investigation, data curation, writing - original draft, writing - review and editing, visualization. TG: conceptualization, methodology, data curation, writing – original draft, writing - review and editing, visualization. EDP: methodology, formal analysis, data curation, writing - review and editing. FT: conceptualization, investigation, data curation, writing - review and editing. SN: conceptualization, investigation, data curation, writing - review and editing. DG: investigation, data curation, writing - review and editing. MS: conceptualization, investigation, data curation, writing - review and editing. Mbo: investigation, data curation, writing - review and editing. AS: investigation, data curation, writing - review and editing. MBe: investigation, data curation, writing - review and editing. MJ: conceptualization, writing - review and editing, supervision. CMB: conceptualization, writing - review and editing, supervision. AAL: conceptualization, investigation, data curation, writing - review and editing. FL: writing - review and editing, supervision. RF: conceptualization, methodology, data curation, writing - review and editing, visualization, supervision, guarantor.

      • 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.