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EV383/#450  Somatic malignancies arising in teratoma in ovarian germ cell tumors – factors affecting survival
  1. Rohini Kulkarni1,
  2. Neha Mittal2,
  3. Biswajit Dash1,
  4. Sneha Raj1,
  5. Tina Nath1,
  6. Jaya Ghosh3,
  7. Seema Gulia3,
  8. Sushmita Rath3,
  9. Santosh Menon2,
  10. Kedar Deodhar2,
  11. Bharat Rekhi2,
  12. Supriya Chopra4,
  13. Sudeep Gupta3 and
  14. Amita Maheshwari1
  1. 1Tata Memorial Centre, Homi Bhabha National Institute, Gynaecologic Oncology, Mumbai, India
  2. 2Tata Memorial Hospital, Tata Memorial Cente, Homi Bhabha National Institute, Pathology, Mumbai, India
  3. 3Tata Memorial Centre, Homi Bhabha National Institute, Medical Oncology, Mumbai, India
  4. 4Tata Memorial Centre, Homi Bhabha National Institute, Radiation Oncology, Mumbai, India

Abstract

Introduction Somatic malignancies arising in teratoma(SMT) in ovarian GCT are rare, there is sparse data available globally. We studied factors influencing survival.

Methods This was a retrospective review of EMR between 2013-2022. Overall and progression free survivals were calculated by Kaplan-Meier method. Cox proportional hazards model was performed to identify factors affecting survival.

Results The study included 34 cases, median age was 51years. SMT arose on a background of mature teratoma in 85%(29/34) and immature teratoma in 15%(5/34). Squamous cell carcinoma(SCC) was most the common SMT(50%;17/34), followed by adenocarcinoma(17.64%;6/34) and others(32.3%;11/34). SMT was detected in recurrent setting in 14.7%(5/34). Non-teratomatous germ cell components seen in 11.8%(4/34). Appropriate cytoreductive/staging surgery performed in 47%(16/34), fertility sparing surgery in 17.6%(6/34). Residual disease was present in 23.5%(8/34). Stage-wise distribution was equal between early(I/II) and advanced stages(III/IV); (47%;16/34 each). Adjuvant chemotherapy administered in 50%(17/34). At median follow-up of 56 months, 26.4%(9/34) patients died of the disease; 8.8%(3/34) were alive with disease. OS and PFS at 4.5years was 59.4%(95%CI:41.5-85.1) and 56%(95%CI:39.5-79.2), respectively (figure 1). On univariate analysis, residual disease and presence of additional non-teratomatous germ cell components were significant poor prognostic factors for OS & PFS, additionally for PFS, detection of SMT at recurrence was significant; histopathology of SMT (SCC vs others), adjuvant treatment were not statistically significant prognostic factors for both OS and PFS. On multivariate analysis, residual disease remained statistically significant (table 1).

Conclusion/Implications Complete surgical resection is crucial for better survival in SMT. The role of adjuvant systemic therapy after complete resection warrants further investigation.

Abstract EV383/#450 Table 1
Abstract EV383/#450 Figure 1

OS and PFS Kaplan-Meier curves

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