To Study the Management and Outcome of Operated Cases of Germ Cell Tumors of Ovary

Abstract

Background: Worldwide ovarian cancer accounts for 225,000 new cases and 140,000 deaths every year. Ovarian germ cell tumors account for 15–20% of all ovarian malignancies and incidence of malignant ovarian germ cell tumors is 2–6%. These tumors typically occur in adolescent girls and young women. Ovarian germ cell tumors (OGCTs) are heterogeneous tumors that are derived from the primitive germ cells of the embryonic gonad, which accounts for about 2.6% of all ovarian malignancies. There are four main types of OGCTs, namely dysgerminomas, yolk sac tumor, teratoma, and choriocarcinoma.

Aim and Objectives: 1. To study the management and outcome of operated cases of Germ cell Tumours of Ovary.2. To Study the proportion of International Federation of Gynecology and Obstetrics (FIGO) Stage.3. Study the of various Types of ovarian germ cell tumor

Methodology: Study Design: A hospital-based retrospective, analytical study.

Study Setting: OBGY department of GGMC, Mumbai, Maharashtra.

Study Population: All Operable cases of Germ cell Tumours of Ovary attending OPD/IPD of OBGY department of GGMC Mumbai such cases were included in the study.

Study Period: 18months from 1 October 2018 to 30 June 2019.

Sample Size = 30

Results: Majority of the patients (30%) were in the age group of 31-40 years followed by 23.4% in the age group of 21-30 years.17 (56.7%) patients were unmarried while 13 (43.3%) patients were married. The most common symptom was abdominal mass and pain (86.7%) followed by irregular menstruation (16.7%).The most common histologic type was dysgerminoma (46.7%) followed by immature teratoma (26.7%). 19 (63.3%) and 6 (20%) patients had FIGO Stage I and II respectively while 4 (13.4%) and 1 (3.3%) patient had FIGO Stage III and IV respectively. All 5 incompletely staged patients with FIGO Stage I underwent FSS in the form of ovarian cystectomy. 7 (36.8%) patients were placed under active surveillance after surgery while 12 (63.2%) patients received adjuvant chemotherapy. 4 (36.4%) patients with FIGO Stage II-IV underwent primary debulking surgery (PDS) followed by adjuvant chemotherapy, whereas 7 (63.6%) patients with FIGO Stage II-IV received neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). In PDS cohort, 3 (75%) patients underwent FSS, whereas in NAC cohort, all patients underwent FSS. In patients with FIGO Stage I, no recurrence was observed in all patients with complete staging surgery and 1 (5.3%) patient with incomplete staging. 3 (15.8%) patients with incomplete surgery showed recurrence and 1 (5.3%) patient with incomplete surgery died. There were no recurrence and no death in all patients with FIGO Stage II-IV.

Conclusions: Surgery has an important role in the management of germ cell tumours. Initial careful surgical staging is of great importance for appropriate subsequent therapy. Fertility sparing surgery is feasible in most cases. Malignant ovarian germ cell tumours have excellent for Stage I and for advanced stages.