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摘要:
目的 回顾性评价恶性生殖细胞肿瘤患者卵巢肿瘤剔除术的临床结局。 方法 回顾1980年1月至2010年12月255例就诊于北京协和医院、病理诊断为恶性生殖细胞肿瘤患者的临床资料, 对其中21例(8%)初次手术为卵巢肿瘤剔除术患者的疗效进行分析。 结果 21例恶性生殖细胞肿瘤患者中, 15例(71%)诊断为未成熟畸胎瘤(Ⅰ级9例, Ⅰ~Ⅱ级3例, Ⅱ级3例), 1例卵黄囊瘤, 4例无性细胞肿瘤, 1例混合生殖细胞肿瘤。术后除3例(未成熟畸胎瘤Ⅰ级2例, Ⅰ~Ⅱ级1例)患者外, 其余18例患者均进行了化疗, 所有患者随访中位时间为52个月(9~178个月), 随访期间除1例混合生殖细胞肿瘤患者术后8个月右卵巢肿瘤复发外, 其余均未复发。2例患者(无性细胞瘤1例, 未成熟畸胎瘤1例)术后成功妊娠, 并分娩足月健康新生儿。 结论 在严密随访下, 对早期无性细胞肿瘤、未成熟畸胎瘤, 甚至卵黄囊瘤患者进行肿瘤剔除术结合必要的化疗能取得满意的治疗效果, 但需要进行更大样本的研究证实单纯肿瘤剔除术对生殖细胞肿瘤患者的痊愈足够有效。 Abstract:Objective To evaluate the clinical outcome of patients who underwent cystectomy only as part of their surgical treatment for malignant ovarian germ cell tumor(MOGCT). Methods Totally 255 MOGCT patients were diagnosed and treated in our department between January 1980 to December 2010.Among them 21 patients underwent cystectomy only as their initial surgery.These 21 patients entered the final analysis. Results Of these 21 MOGCT patients, 15 were with immature teratoma[Grade 1, n=9;grade 1-2, n=4;grade 2, n=2), one with yolk sac tumor, four with dysgerminoma, and one with mixed germ cell tumor.All except three patients(two with grade 1 and one with grade 1-2 disease)received adjuvant chemotherapy.All patients were followed up, with a median duration of 52 months.No recurrence was observed during this period except one patient experienced mixed germ cell tumor.Two patients(one with dysgeminoma and one with immature teratoma)successfully became pregnant and delivered healthy babies. Conclusions Cystectomy followed by adjuvant chemotherapy can achieve satisfactory effectiveness for apparent early-stage immature teratoma, dysgerminoma, and even yolk sac tumor under close follow-up.However, studies with larger samples are required to confirm whether cystectomy alone is enough for curing MOGCT. -
Key words:
- malignant ovarian germ cell tumors /
- cystectomy /
- clinical outcome
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表 1 21例卵巢恶性生殖细胞肿瘤剔除术患者的临床资料
患者 年龄(岁) 初次手术 手术方式 本院/外院 病理 组织级别 化疗 孕产情况 复发 结局(NED月数) 1 26 肿瘤剔除 开腹 外院 无性细胞瘤 - PEB*3 G2P0 否 93 2 20 肿瘤剔除+分期 开腹 本院 未成熟畸胎瘤 Ⅰ-Ⅱ PVB*3 G0P0 否 121 3 13 肿瘤剔除 开腹 外院 未成熟畸胎瘤 Ⅰ PVB*3 G0P0 否 178 4 8 肿瘤剔除 开腹 外院 无性细胞瘤 - PE*3, VAC*3 G0P0 否 163 5 15 肿瘤剔除 开腹 外院 未成熟畸胎瘤 Ⅰ-Ⅱ 未化疗 G0P0 否 166 6 36 肿瘤剔除 开腹 本院 无性细胞瘤 - PVB*2 G1P1 否 132 7 29 肿瘤剔除 开腹 外院 混合性(畸胎瘤鳞癌或胚胎癌) - PEB*2 G0P0 是 失访 8 30 肿瘤剔除 开腹 本院 无性细胞瘤 - PEB*4 G2P1 否 76 9 19 肿瘤剔除 开腹 外院 未成熟畸胎瘤 Ⅰ PEB*3 G0P0 否 71 10 22 肿瘤剔除 开腹 本院 未成熟畸胎瘤 Ⅰ PEB*3 G0P0 否 60 11 27 肿瘤剔除 腹腔镜 本院 未成熟畸胎瘤 Ⅰ PEB*4 G0P0 否 56 12 18 肿瘤剔除 腹腔镜 本院 未成熟畸胎瘤 Ⅰ PEB*3 G0P0 否 24 13 26 肿瘤剔除 开腹 外院 未成熟畸胎瘤 Ⅱ PEB*4 G0P0 否 52 14 16 肿瘤剔除 开腹 外院 未成熟畸胎瘤 Ⅱ PEB*3 G0P0 否 48 15 11 肿瘤剔除 开腹 外院 未成熟畸胎瘤 Ⅰ VAC*3 G0P0 否 30 16 18 肿瘤剔除 开腹 外院 卵黄囊瘤 - PEB*5 G0P0 否 42 17 34 肿瘤剔除 腹腔镜 本院 未成熟畸胎瘤 Ⅰ PEB*2 G3P1 否 28 18 15 肿瘤剔除 开腹 外院 未成熟畸胎瘤 Ⅰ-Ⅱ PEB*4 G3P1 否 12 19 36 肿瘤剔除 腹腔镜 本院 未成熟畸胎瘤 Ⅰ 未化疗 G2P0 否 17 20 31 肿瘤剔除 腹腔镜 本院 未成熟畸胎瘤 Ⅰ 未化疗 G3P0 否 9 21 32 肿瘤剔除 开腹 本院 未成熟畸胎瘤 Ⅱ PEB*3 G2P 否 16 FSH:卵泡刺激素; E2:雌二醇; 与术前比较, *P＜0. 05 
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[1] Abu-Rustum N, Aghajanian C. Management of malignant germ cell tumors of the ovary[J].Semin Oncol, 1998, 25: 235-242. [2] Seli E, Tangir J.Fertility preservationoptions for female patients with malignancies[J].Curr Opin Obstet Gynecol, 2005, 17:299-308. doi: 10.1097/01.gco.0000169108.15623.34 [3] FIGO Cancer Committee.Staging announcement[J].Gynecol Oncol, 1986, 25:383-385. doi: 10.1016/0090-8258(86)90092-2 [4] Talerman A.Germ cell tumors of the ovary[M] //Kurman RJ.Blaustein' s pathology of the female genital tract.4th ed.New York: Springer-Verlag, 1994: 849-914. [5] Befna UD, Umadevi K, Kumaran L, et al.Germ cell tumors of the ovary:is there a role for aggressive cytoreductive surgery for non-dysgerm inomatous tumors[J].Int J Gynecol Cancer, 2001, 11:300-304. doi: 10.1136/ijgc-00009577-200107000-00008 [6] Beiner ME, Gotlieb WH, Korach Y, et al.Cystectomy for immature teratoma of the ovary[J].Gynecol Oncol, 2004, 93:381-384. doi: 10.1016/j.ygyno.2004.01.034 [7] Mangili G, Scarfone G, Gadducci A, et al.Is adjuvant chemotherapy indicated in stage I pure immature ovarian teratoma? A multicentre Italian trial inovarian cancer(MITO-9) [J].Gynecol Oncol, 2010, 119:48-52. doi: 10.1016/j.ygyno.2010.05.035 [8] Weinberg LE, Lurain JR, Singh DK, et al.Survival and reproductive outcomes in women treated for malignant ovarian germ cell tumors[J].Gynecol Oncol, 2011, http://www.elsevier.com/ygyno. -
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