Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapy
ObjectiveImmature teratomas are rare malignant ovarian germ cell tumours, typically diagnosed in young women, where fertility-sparing surgery is the treatment of choice. The role of adjuvant chemotherapy in stage I disease remains controversial. We evaluated the impact of surveillance versus chemoth...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1330481/full |
| _version_ | 1827365236517109760 |
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| author | Giuseppe Marino Tommaso Grassi Elena De Ponti Serena Negri Filippo Testa Daniela Giuliani Martina Delle Marchette Cristina Dell’Oro Diletta Fumagalli Gianluca Donatiello Giulia Besana Liliana Marchetta Cristina Maria Bonazzi Andrea Alberto Lissoni Fabio Landoni Fabio Landoni Robert Fruscio Robert Fruscio |
| author_facet | Giuseppe Marino Tommaso Grassi Elena De Ponti Serena Negri Filippo Testa Daniela Giuliani Martina Delle Marchette Cristina Dell’Oro Diletta Fumagalli Gianluca Donatiello Giulia Besana Liliana Marchetta Cristina Maria Bonazzi Andrea Alberto Lissoni Fabio Landoni Fabio Landoni Robert Fruscio Robert Fruscio |
| author_sort | Giuseppe Marino |
| collection | DOAJ |
| description | ObjectiveImmature teratomas are rare malignant ovarian germ cell tumours, typically diagnosed in young women, where fertility-sparing surgery is the treatment of choice. The role of adjuvant chemotherapy in stage I disease remains controversial. We evaluated the impact of surveillance versus chemotherapy on the recurrence rate in stage I immature teratomas.MethodsWe collected a single centre retrospective series of patients with stage I immature teratomas treated with fertility-sparing surgery at San Gerardo Hospital, Monza, Italy, between 1980 and 2019. Potential risk factors for recurrence were investigated by multivariate logistic regression.ResultsOf the 74 patients included, 12% (9/74) received chemotherapy, while 88% (65/74) underwent surveillance. Median follow-up was 188 months. No difference in recurrence was found in stage IA/IB and IC immature teratomas [10% (6/60) vs. 28.6% (4/14) (P=0.087)], grade 1, grade 2, and grade 3 [7.1% (2/28) vs. 14.3% (4/28) vs. 22.2% (4/18) (p=0.39)], and surveillance versus chemotherapy groups [13.9% (9/65) vs. 11.1% (1/9)) (p = 1.00)]. In univariate analysis, the postoperative approach had no impact on recurrence. The 5-year disease-free survival was 87% and 90% in the surveillance and chemotherapy groups, respectively; the overall survival was 100% in both cohorts.ConclusionsOur results support the feasibility of surveillance in stage I immature teratomas. Adjuvant chemotherapy may be reserved for relapses. However, the potential benefit of chemotherapy should be discussed, especially for high-risk tumours. Prospective series are warranted to confirm our findings.What is already known on this topicTo date, no consensus has been reached regarding the role of adjuvant chemotherapy in stage I immature teratomas of the ovary. Some studies suggest that only surveillance is an acceptable choice. However, guidelines are not conclusive on this topic.What this study addsNo difference in terms of recurrence was observed between the surveillance and the adjuvant chemotherapy group. All patients who relapsed were successfully cured with no disease-related deaths.How this study might affect research, practice or policyAdjuvant chemotherapy should be appropriately discussed with patients. However, it may be reserved for relapse according to our data. |
| first_indexed | 2024-03-08T08:24:18Z |
| format | Article |
| id | doaj.art-49229fe9d8184c139625babdf4d1cb60 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T08:24:18Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-49229fe9d8184c139625babdf4d1cb602024-02-02T04:51:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-02-011410.3389/fonc.2024.13304811330481Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapyGiuseppe Marino0Tommaso Grassi1Elena De Ponti2Serena Negri3Filippo Testa4Daniela Giuliani5Martina Delle Marchette6Cristina Dell’Oro7Diletta Fumagalli8Gianluca Donatiello9Giulia Besana10Liliana Marchetta11Cristina Maria Bonazzi12Andrea Alberto Lissoni13Fabio Landoni14Fabio Landoni15Robert Fruscio16Robert Fruscio17Department of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyUnit of Gynecology, Woman and Child Department, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Gerardo, Monza, ItalyUnit of Gynecology, Woman and Child Department, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Gerardo, Monza, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyUnit of Gynecology, Woman and Child Department, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Gerardo, Monza, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyUnit of Gynecology, Woman and Child Department, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Gerardo, Monza, ItalyUnit of Gynecology, Woman and Child Department, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Gerardo, Monza, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyUnit of Gynecology, Woman and Child Department, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Gerardo, Monza, ItalyDepartment of Medicine and Surgery, University of Milan-Bicocca, Milan, ItalyUnit of Gynecology, Woman and Child Department, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Gerardo, Monza, ItalyObjectiveImmature teratomas are rare malignant ovarian germ cell tumours, typically diagnosed in young women, where fertility-sparing surgery is the treatment of choice. The role of adjuvant chemotherapy in stage I disease remains controversial. We evaluated the impact of surveillance versus chemotherapy on the recurrence rate in stage I immature teratomas.MethodsWe collected a single centre retrospective series of patients with stage I immature teratomas treated with fertility-sparing surgery at San Gerardo Hospital, Monza, Italy, between 1980 and 2019. Potential risk factors for recurrence were investigated by multivariate logistic regression.ResultsOf the 74 patients included, 12% (9/74) received chemotherapy, while 88% (65/74) underwent surveillance. Median follow-up was 188 months. No difference in recurrence was found in stage IA/IB and IC immature teratomas [10% (6/60) vs. 28.6% (4/14) (P=0.087)], grade 1, grade 2, and grade 3 [7.1% (2/28) vs. 14.3% (4/28) vs. 22.2% (4/18) (p=0.39)], and surveillance versus chemotherapy groups [13.9% (9/65) vs. 11.1% (1/9)) (p = 1.00)]. In univariate analysis, the postoperative approach had no impact on recurrence. The 5-year disease-free survival was 87% and 90% in the surveillance and chemotherapy groups, respectively; the overall survival was 100% in both cohorts.ConclusionsOur results support the feasibility of surveillance in stage I immature teratomas. Adjuvant chemotherapy may be reserved for relapses. However, the potential benefit of chemotherapy should be discussed, especially for high-risk tumours. Prospective series are warranted to confirm our findings.What is already known on this topicTo date, no consensus has been reached regarding the role of adjuvant chemotherapy in stage I immature teratomas of the ovary. Some studies suggest that only surveillance is an acceptable choice. However, guidelines are not conclusive on this topic.What this study addsNo difference in terms of recurrence was observed between the surveillance and the adjuvant chemotherapy group. All patients who relapsed were successfully cured with no disease-related deaths.How this study might affect research, practice or policyAdjuvant chemotherapy should be appropriately discussed with patients. However, it may be reserved for relapse according to our data.https://www.frontiersin.org/articles/10.3389/fonc.2024.1330481/fullimmature teratoma of the ovarygerm cell tumorchemotherapyoncologic outcomeovarian cancer |
| spellingShingle | Giuseppe Marino Tommaso Grassi Elena De Ponti Serena Negri Filippo Testa Daniela Giuliani Martina Delle Marchette Cristina Dell’Oro Diletta Fumagalli Gianluca Donatiello Giulia Besana Liliana Marchetta Cristina Maria Bonazzi Andrea Alberto Lissoni Fabio Landoni Fabio Landoni Robert Fruscio Robert Fruscio Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapy Frontiers in Oncology immature teratoma of the ovary germ cell tumor chemotherapy oncologic outcome ovarian cancer |
| title | Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapy |
| title_full | Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapy |
| title_fullStr | Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapy |
| title_full_unstemmed | Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapy |
| title_short | Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapy |
| title_sort | outcome of patients with stage i immature teratoma after surveillance or adjuvant chemotherapy |
| topic | immature teratoma of the ovary germ cell tumor chemotherapy oncologic outcome ovarian cancer |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1330481/full |
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