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首页> 外文期刊>World Journal of Surgical Oncology >Residual tumor after the salvage surgery is the major risk factors for primary treatment failure in malignant ovarian germ cell tumors: A retrospective study of single institution
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Residual tumor after the salvage surgery is the major risk factors for primary treatment failure in malignant ovarian germ cell tumors: A retrospective study of single institution

机译：挽救手术后残留的肿瘤是卵巢恶性生殖细胞肿瘤一级治疗失败的主要危险因素：单机构回顾性研究

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Background Malignant ovarian germ cell tumors are rare, and knowledge of their prognostic factors is limited, with little available randomized data. This study was conducted to evaluate the clinicopathologic characteristics of malignant ovarian germ cell tumors and to determine the association of their prognostic factors to primary treatment failure. Methods The medical records of 57 patients with stages I to IV malignant ovarian germ cell tumor were retrospectively reviewed, and their clinicopathologic and treatment-related data were collected and analyzed. Results The median age at the diagnosis was 23.3 years (range: 8-65 years), and the median follow-up period was 108 months (range: 48-205 months). The histological types of the tumors were immature teratoma (n = 24), dysgerminoma (n = 20), endodermal sinus tumor (n = 8), mixed germ cell tumor (n = 4), and choriocarcinoma (n = 1). 66.7% of the patients had stage I disease; 5.2%, stage II; 26.3%, stage III; and 1.8%, stage IV. After the initial surgery, 49 patients (86%) received cisplatin-based chemotherapy. The five-year survival rate was 96.5%. There were six primary treatment failures, with two of the patients dying of the disease, and the median time to the recurrence was 8 months. The histological diagnosis (P < 0.0001), tumor stage (P = 0.0052), elevation of beta-hCG (P = 0.0134), operation methods (P = 0.0006), and residual tumor after the salvage surgery (P < 0.0001) were significantly associated with the risk of primary treatment failure in the univariate analysis. In the multivariate analysis, the residual tumor after the salvage surgery was the only significant variable associated with primary treatment failure (P = 0.0011, Hazard ratio = 29.046, 95% Confidence interval 3.832-220.181). Conclusion Most malignant ovarian germ cell tumors have excellent prognoses with primary treatment, and good reproductive outcomes can be expected. Because primary treatment failure is associated with the residual disease after the salvage surgery, knowledge of the presence or absence of this risk factor may be helpful in risk stratification and individualization of adjuvant therapy in malignant ovarian germ cell tumors. Further large-scale prospective studies to confirm these results should be performed.
机译：背景卵巢生殖细胞恶性肿瘤十分罕见，其预后因素的知识有限，几乎没有可用的随机数据。这项研究旨在评估恶性卵巢生殖细胞肿瘤的临床病理特征，并确定其预后因素与主要治疗失败的关联。方法回顾性分析57例I至IV期恶性卵巢生殖细胞肿瘤的病历，并收集和分析其临床病理和治疗相关数据。结果诊断时的中位年龄为23.3岁（范围：8-65岁），中位随访期为108个月（范围：48-205个月）。肿瘤的组织学类型为未成熟畸胎瘤（n = 24），不典型性乳腺瘤（n = 20），内膜窦肿瘤（n = 8），混合生殖细胞肿瘤（n = 4）和绒癌（n = 1）。 66.7％的患者患有I期疾病; 5.2％，第二阶段;第三阶段26.3％;第四阶段占1.8％。初次手术后，有49例患者（86％）接受了以顺铂为基础的化疗。五年生存率为96.5％。有六项主要治疗失败，其中两名患者死于疾病，中位复发时间为8个月。挽救手术后的组织学诊断（P <0.0001），肿瘤分期（P = 0.0052），β-hCG升高（P = 0.0134），手术方法（P = 0.0006）和残留肿瘤均显着（P <0.0001）在单因素分析中与主要治疗失败的风险相关。在多变量分析中，挽救手术后的残留肿瘤是与主要治疗失败相关的唯一显着变量（P = 0.0011，危险比= 29.046，95％置信区间3.832-220.181）。结论多数恶性卵巢生殖细胞肿瘤经初步治疗均具有良好的预后，并有望获得良好的生殖效果。由于一级治疗失败与挽救手术后的残余疾病有关，因此了解此危险因素的存在或不存在可能有助于对恶性卵巢生殖细胞肿瘤进行危险性分层和辅助治疗的个体化。应进行进一步的大规模前瞻性研究以证实这些结果。

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