Ovarian germ cell tumor surgery: Difference between revisions

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{| class="wikitable"
{| class="wikitable"
|+
|+
!
! colspan="2" |Management of Mature Teratoma
!
!
|-
|-
|Mature Teratoma
|Mature Teratoma
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**No plans for future [[pregnancy]]
**No plans for future [[pregnancy]]
**[[Menopausal|Post-menopausal]] women
**[[Menopausal|Post-menopausal]] women
|
|-
|-
!
! colspan="2" |Management of [[Dysgerminoma|Dysgerminomas]]<ref name="xxx" /><ref name="abc" /><ref name="aaa" /><ref name="ccc" />
!Management of [[Dysgerminoma|Dysgerminomas]]<ref name="xxx" /><ref name="abc" /><ref name="aaa" /><ref name="ccc" />
!Other tumors
|-
|-
|Stage I ovarian germ cell tumors
|Stage I ovarian germ cell tumors
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* Patients with [[Surgery|surgically]] staged stage IA [[tumors]] may be observed carefully after [[surgery]] without the need for [[adjuvant treatment]].
* Patients with [[Surgery|surgically]] staged stage IA [[tumors]] may be observed carefully after [[surgery]] without the need for [[adjuvant treatment]].
* Patients with incompletely staged [[tumor]] through [[surgery]] or those with higher stages may need [[adjuvant treatment]].
* Patients with incompletely staged [[tumor]] through [[surgery]] or those with higher stages may need [[adjuvant treatment]].
|
|-
|-
|Stage II ovarian germ cell tumors
|Stage II ovarian germ cell tumors
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** [[Radiotherapy]] has been associated with [[ovarian failure]].
** [[Radiotherapy]] has been associated with [[ovarian failure]].
** [[Adjuvant]] [[chemotherapy]] with the [[platinum]]-based regimen has replaced [[radiation therapy]] except in the rare patient in whom [[chemotherapy]] is not considered appropriate.
** [[Adjuvant]] [[chemotherapy]] with the [[platinum]]-based regimen has replaced [[radiation therapy]] except in the rare patient in whom [[chemotherapy]] is not considered appropriate.
|
|-
|-
|Stage III ovarian germ cell tumors
|Stage III ovarian germ cell tumors
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:** This strategy is not beneficial in patients with completely resected [[tumors]] who receive [[cisplatin]]-based [[adjuvant treatment]].
:** This strategy is not beneficial in patients with completely resected [[tumors]] who receive [[cisplatin]]-based [[adjuvant treatment]].
:** Second-look [[surgery]] may be beneficial in those whose [[tumor]] was not completely resected at the initial [[surgical]] procedure and who had teratomatous elements in their primary [[tumor]].
:** Second-look [[surgery]] may be beneficial in those whose [[tumor]] was not completely resected at the initial [[surgical]] procedure and who had teratomatous elements in their primary [[tumor]].
|
|-
|-
|Stage IV ovarian germ cell tumors
|Stage IV ovarian germ cell tumors
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:* Unilateral [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]]
:* Unilateral [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]]
:** [[Chemotherapy]] is the preferred treatment in the patient who wants to preserve [[fertility]].
:** [[Chemotherapy]] is the preferred treatment in the patient who wants to preserve [[fertility]].
|}
===Management options of Other Ovarian Tumors===
:*
{| class="wikitable"
|+
! colspan="2" |Surgical options for other ovarian tumors
|-
|Stage I ovarian germ cell tumors
|
* Unilateral [[salpingo-oophorectomy]] with [[adjuvant chemotherapy]]
* Unilateral [[salpingo-oophorectomy]] followed by [[observation]]
* Unilateral [[salpingo-oophorectomy]] with conservation of [[uterus]] and contralateral [[ovar]] is [[Indication (medicine)|indicated]] in those who plan for future [[pregnancies]].
* [[Chemotherapy agent|Chemotherapy]] is usually done postoperatively in those with [[ovarian]] [[germ cell]] [[tumors]] other than pure [[dysgerminoma]] and low grade (grade 1) immature [[teratoma]], but it can also preserved for those whose [[tumors]] [[relapse]] after the [[surgery]].
|-
|Stage II ovarian germ cell tumors
|
* Total [[abdominal]] [[hysterectomy]] and [[bilateral]] [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]], with or without [[neoadjuvant chemotherapy]]
* Unilateral [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]], with or without [[neoadjuvant chemotherapy]]
* Second-look [[laparotomy]]
|-
|Stage III ovarian germ cell tumors
|
|
* Total [[abdominal]] [[hysterectomy]] and [[bilateral]] [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]]
* Unilateral [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]]
|-
|Stage IV ovarian germ cell tumors
|
* Total [[abdominal]] [[hysterectomy]] and [[bilateral]] [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]] with or without [[neoadjuvant chemotherapy]]
* Unilateral [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]] with or without [[neoadjuvant chemotherapy]]
|}
|}
===Mature teratoma===
**
===Management of ===
* [[Surgery]] is the mainstay of treatment in [[Dysgerminoma|dysgerminomas]].
* Depending upon the staging and severity adjuavant Additional [[chemotherapy]] and/or [[radiotherapy]] depend on the [[stage]] of the [[tumor]].<ref name="VicusBeiner2010">{{cite journal|last1=Vicus|first1=Danielle|last2=Beiner|first2=Mario E.|last3=Klachook|first3=Shany|last4=Le|first4=Lisa W.|last5=Laframboise|first5=Stephane|last6=Mackay|first6=Helen|title=Pure dysgerminoma of the ovary 35 years on: A single institutional experience|journal=Gynecologic Oncology|volume=117|issue=1|year=2010|pages=23–26|issn=00908258|doi=10.1016/j.ygyno.2009.12.024}}</ref>
* Stage 1A: [[fertility]]-preserving [[surgery]] without [[adjuvant]] [[chemotherapy]] or [[radiotherapy]].<ref name="AL HusainiSoudy2012">{{cite journal|last1=AL Husaini|first1=Hamed|last2=Soudy|first2=Hussein|last3=Darwish|first3=Alaa El Din|last4=Ahmed|first4=Mohamed|last5=Eltigani|first5=Amin|last6=AL Mubarak|first6=Mustafa|last7=Sabaa|first7=Amal Abu|last8=Edesa|first8=Wael|last9=AL-Tweigeri|first9=Taher|last10=Al-Badawi|first10=Ismail A.|title=Pure dysgerminoma of the ovary: a single institutional experience of 65 patients|journal=Medical Oncology|volume=29|issue=4|year=2012|pages=2944–2948|issn=1357-0560|doi=10.1007/s12032-012-0194-z}}</ref>
**
* Other [[germ cell]] [[tumors]]
:* Unilateral [[salpingo-oophorectomy]] with [[adjuvant chemotherapy]]
:* Unilateral [[salpingo-oophorectomy]] with [[adjuvant chemotherapy]]
:* Unilateral [[salpingo-oophorectomy]] followed by [[observation]]
:* Unilateral [[salpingo-oophorectomy]] followed by [[observation]]

Revision as of 23:57, 10 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]

Overview

Surgical intervention is the mainstay of management of ovarian germ cell tumors. Surgery is recommended both for staging and choosing appropriate treatment approaches. accordingly. Surgical management of the ovarian germ cell tumors, for the purpose of treatment, classified to two categories according to the preference of the patient to preserve the ovary or not.

Surgery

Management of Mature Teratoma
Mature Teratoma
Management of Dysgerminomas[1][2][3][4]
Stage I ovarian germ cell tumors
Stage II ovarian germ cell tumors
Stage III ovarian germ cell tumors
Stage IV ovarian germ cell tumors

Management options of Other Ovarian Tumors

Surgical options for other ovarian tumors
Stage I ovarian germ cell tumors
Stage II ovarian germ cell tumors
Stage III ovarian germ cell tumors
Stage IV ovarian germ cell tumors

References

  1. ↑ 1.0 1.1 1.2 1.3 Stage I Ovarian Germ Cell Tumors . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_33. URL Accessed on Nov 5, 2015
  2. ↑ 2.0 2.1 2.2 2.3 Stage II Ovarian Germ Cell Tumors . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_43. URL Accessed on Nov 5, 2015
  3. ↑ 3.0 3.1 3.2 3.3 Stage III Ovarian Germ Cell Tumors . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_54. URL Accessed on Nov 5, 2015
  4. ↑ 4.0 4.1 4.2 4.3 Stage IV Ovarian Germ Cell Tumors . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_65. URL Accessed on Nov 5, 2015
  5. ↑ Gershenson, David M. (2007). "Management of Ovarian Germ Cell Tumors". Journal of Clinical Oncology. 25 (20): 2938–2943. doi:10.1200/JCO.2007.10.8738. ISSN 0732-183X.
  6. ↑ Yayla Abide, Çiğdem; Bostancı Ergen, Evrim (2018). "Retrospective analysis of mature cystic teratomas in a single center and review of the literature". Journal of Turkish Society of Obstetric and Gynecology. 15 (2): 95–98. doi:10.4274/tjod.86244. ISSN 1307-699X.
  7. ↑ 7.0 7.1 Caspi, Benjamin; Appelman, Zvi; Rabinerson, David; Zalel, Yaron; Tulandi, Togas; Shoham, Zeev (1997). "The growth pattern of ovarian dermoid cysts: a prospective study in premenopausal and postmenopausal women". Fertility and Sterility. 68 (3): 501–505. doi:10.1016/S0015-0282(97)00228-8. ISSN 0015-0282.

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