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Is surgical restaging indicated in apparent stage IA pure ovarian dysgerminoma? The MITO group retrospective experience.

Abstract：

OBJECTIVE:Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for pure ovarian dysgerminoma (POD), except for correctly staged IA patients. The aim of study was to evaluate the outcome of IA POD patients with incomplete surgical staging in order to define the proper management. METHODS:Data concerning primary treatment and recurrence were reviewed for 26 patients with stage IA POD treated in MITO (Multicenter Italian Trials in Ovarian Cancer) centers. RESULTS:Median age was 22.5years. Primary surgery was fertility sparing for 17 patients (65.4%) and radical surgery was performed in 9 patients due to older age or gonadal dysgenesis. Only five patients (19.2%) had complete surgical staging; 38.5% had lymph node dissection, 46.2% had peritoneal biopsies and/or omentectomy and 65.4% had peritoneal washing. Seven patients received adjuvant chemotherapy. Overall recurrence rate was 11.5%: all recurrences occurred in the group submitted to incomplete staging procedure. No patients treated with adjuvant chemotherapy relapsed. One patient had pelvic recurrence, one patient relapsed in the abdomino-pelvic peritoneum and lymph nodes and the third patient showed a peritoneum, lymph nodal and residual ovary relapse. All patients with recurrence were cured by salvage therapy: 2 patients were treated with surgery plus chemotherapy and one only with chemotherapy. After a median follow-up of 100months all patients are alive without evidence of disease. Six patients opted for conception and delivered healthy infants, two with IVF with donor oocyte. CONCLUSIONS:IA POD prognosis is excellent. Conservative surgery with a complete surgical staging is the gold standard. Patients with incomplete staging could undergo surgical restaging or surveillance. Chemotherapy should be reserved to relapse with excellent chances of therapeutic success.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Mangili G,Sigismondi C,Lorusso D,Cormio G,Scollo P,Viganò R,Gamucci T,Candiani M,Pignata S

doi

10.1016/j.ygyno.2011.01.006

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

280-4

issue

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(11)00018-7

journal_volume

121

pub_type

杂志文章,多中心研究

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Is surgical restaging indicated in apparent stage IA pure ovarian dysgerminoma? The MITO group retrospective experience.