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Clinicopathological Characteristics and Treatment Outcomes of Pregnancy Complicated by Malignant Ovarian Germ Cell Tumors

Authors Zong X, Yang JX, Zhang Y, Cao DY, Shen K

Received 2 December 2019

Accepted for publication 13 February 2020

Published 24 February 2020 Volume 2020:12 Pages 1347—1354


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Rudolph Navari

Xuan Zong, Jia-Xin Yang, Ying Zhang, Dong-Yan Cao, Keng Shen

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China

Correspondence: Jia-Xin Yang
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, People’s Republic of China
Tel +86 10 6915 4022
Fax +86 10 6915 5635

Purpose: This study aimed to analyze the clinicopathological features, treatment, and feto-maternal outcomes of pregnancy complicated by malignant ovarian germ cell tumors (MOGCTs), to increase the awareness on this condition.
Patients and Methods: We retrospectively reviewed the medical records of patients diagnosed with MOGCTs during pregnancy, who were treated and followed-up at Peking Union Medical College Hospital from January 2000 to December 2017. The demographic characteristics, pathological features, treatment and prognosis were analyzed.
Results: The histological subtypes varied in 14 patients (dysgerminoma, n=1; immature teratoma, n=4; yolk sac tumor, n=6; and mixed germ cell tumors, n=3). Ten (71.4%) patients, including three who opted for conservative therapy until childbirth, one who only received salvage chemotherapy during pregnancy, and six who underwent cystectomy or unilateral salpingo-oophorectomy during pregnancy, desired fetal preservation. After undergoing surgery, four patients chose surveillance instead of timely adjuvant chemotherapy. Eight patients delivered their babies, and the preterm delivery rate was 50.0%. One newborn died of premature birth. The median follow-up period was 44 (range: 13 to 86) months. During the current study period, 12 patients had survived and did not report any diseases. However, two died due to disease progression.
Conclusion: Pregnant women with MOGCTs had favorable outcomes. However, when a malignant tumor is suspected, surgery cannot be avoided. Thus, instead of timely postoperative adjuvant chemotherapy, close surveillance may be an acceptable alternative for pregnant women with low-risk MOGCTs.

Keywords: pregnancy, germ cell tumor, expectant management, retrospective studies

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