Malign over germ hücreli tümörlerde klinikopatolojik özelliklerin prognoza etkisi

Year 2023, Volume: 48 Issue: 1, 54 - 63, 31.03.2023

Yegana Seyidova , Sevtap Seyfettinoğlu , Ümran Küçükgöz Güleç , Ghanim Khatib , Ahmet Barış Güzel , Derya Gümürdülü , Semra Paydaş , Mehmet Ali Vardar

https://doi.org/10.17826/cumj.1176706

Abstract

Amaç: Malign over germ hücreli tümörleri, yumurtalık kanserlerinin %5'ine neden olur. Malign over germ hücreli tümörlerin nadir görülmesi nedeniyle prognoz ve sağkalım oranlarını inceleyen çalışmalar önemlidir. Çalışmamızda bu hastalarda sonuç ve prognostik faktörleri araştırmayı amaçladık.
Gereç ve Yöntem: Çalışma, Nisan 1992 ile Kasım 2017 tarihleri arasında kliniğimizde tedavi olmuş malign over germ hücreli tümör hastalarının klinikopatolojik kayıtlarını içermektedir. Demografik ve klinik özellikler, patolojik gözlemler, adjuvan tedavi modaliteleri ve takip detayları analiz edilerek sağkalıma etkileri araştırılmıştır.
Bulgular: Malign over germ hücreli tümörleri olan yüz onbeş hasta çalışmaya dahil edildi. Hastaların çoğu üreme çağındaki nullipar kadınlardı. Hastaların yaş ortalaması 27.5+14.3, ortalama takip süresi 71.04 ay idi. Araştırma 42 disgerminom, 37 immatür teratom, 17 miks germ hücreli tümör, 16 endodermal sinüs tümörü ve üç embriyonik karsinom olgusu içermektedir. Hastalık evresi sırasıyla hastaların %53'ünde %16.5, %25.2'sinde ve %5.2'sinde Evre 1, 2, 3 ve 4 idi.
Yetmişdokuz hastanın 55'ine fertilite koruyucu cerrahi uygulandı ve hastaların %34.5'inde gebelik elde edildi. Beş yıllık genel sağkalım %74 idi. Tümörlerin lokalizasyonu, optimal olmayan sitoredüksiyon, ileri evre hastalık, kötü farklılaşma, metastaz, mikst hücre histolojisi kötü prognostik faktörler olarak belirlendi. Çok değişkenli analizlerde hastalıksız sağkalımı etkileyen faktörler FIGO evresi, mikst germ hücre histolojisi ve suboptimal sitoredüksiyon olarak saptandı.
Sonuç: Malign over germ hücreli tümörlerin prognozu, özellikle genç, erken evre ve uygun şekilde ameliyat edilmiş hastalarda mükemmeldir. FIGO Evresi, mikst germ hücre histopatolojisi ve tam sitoredüksiyon, MOGCT'nin prognozunu etkileyen faktörlerdir. Üreme çağındaki tedavi gebelik sonuçlarını önemli ölçüde etkilemez. Bu nedenle, özellikle genç hastalarda koruyucu yaklaşım da iyi bir seçenek olarak düşünülmelidir.

Keywords

Malign germ hücreli tümör, yumurtalık kanseri, prognoz, fertilite koruyucu cerrahi

The effect of clinicopathological features on prognosis in malignant ovarian germ cell tumors

Abstract

Purpose: Malignant ovarian germ cell tumors cause 5% of ovarian cancers. Studies examining prognosis and survival rates are significant due to malignant ovarian germ cell tumors' rarity. We aimed to investigate outcome and prognostic factors in these patients.
Materials and Methods: The study includes clinicopathological records of malignant ovarian germ cell tumor patients in our clinic between April 1992 and November 2017. Demographic and clinical characteristics, pathological observations, adjuvant treatment modalities, and follow-up details were analyzed, and their survival effects were investigated.
Results: One hundred fifteen patients with malignant ovarian germ cell tumors were analyzed. Most patients were reproductive-age nulliparous. The patients' mean age was 27.5+14.3, and the mean follow-up was 71.04 months. The research includes 42 dysgerminomas, 37 immature teratomas, 17 mixed germ-cell tumors, 16 endodermal sinus tumors, and three embryonic carcinomas. The disease stage was 1, 2, 3, and 4 in 53%, 16.5%, 25.2%, and 5.2% of patients, respectively.
Fertility-sparing surgery was conducted in 55 of 79 patients, and 34.5% received pregnancy. Five-year overall survival was 74%. Localization of tumors, non-optimal cytoreduction, advanced-stage disease, poor differentiation, metastasis, and mixed cell histology were determined as poor prognostic factors. In multivariate analyzes, factors affecting disease-free survival are the FIGO stage, mixed germ cell histology, and suboptimal cytoreduction.
Conclusion: The prognosis of malignant ovarian germ cell tumors is excellent, especially in young, early-stage, and adequately operated patients. FIGO Stage, mixed germ cell histopathology and complete cytoreduction affect the prognosis of MOGCT. Treatment at reproductive age does not significantly affect pregnancy outcomes. Therefore, the fertility sparring approach should be considered a good option, especially in young patients.

Keywords

Malignant germ cell tumor, ovarian cancer, fertility-sparing surgery, prognosis

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