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Arch Gynecol Obstet. 2019 Apr 13. doi: 10.1007/s00404-019-05160-6. [Epub ahead of print]

Prognostic factors and oncological outcomes of ovarian yolk sac tumors: a retrospective multicentric analysis of 99 cases.

Author information

1
Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Etlik, 06010, Ankara, Turkey. gokhan.boyraz@gmail.com.
2
Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Etlik, 06010, Ankara, Turkey.
3
Department of Medical Oncology, Trakya University Hospital, 22030, Edirne, Turkey.
4
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
5
Department of Gynecologic Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.
6
Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health, Education and Research Hospital, Ankara, Turkey.
7
Department of Gynecologic Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
8
Antalya Education and Research Hospital Faculty of Medicine, University of Health Sciences (Antalya), Antalya, Turkey.

Abstract

PURPOSE:

To investigate the clinico-pathological prognostic factors and treatment outcomes in patients with ovarian yolk sac tumors (YST).

METHODS:

A multicenter, retrospective department database review was performed to identify patients with ovarian YST who underwent surgery between 2000 and 2017 at seven Gynecologic Oncology Centers in Turkey.

RESULTS:

The study group consisted of 99 consecutive patients with a mean age of 23.9 years. While 52 patients had early stage (stage I-II) disease, the remaining 47 patients had advanced stage (stage III-IV) disease. The uterus was preserved in 74 (74.8%) of the cases. The absence of gross residual disease following surgery was achieved in 76.8% of the cases. Of the 54 patients with lymph node dissection (LND), lymph node metastasis was detected in 10 (18.5%) patients. Of the 99 patients, only 3 patients did not receive adjuvant therapy, and most of the patients (91.9%) received BEP (bleomycin, etoposide, cisplatin) chemotherapy. Disease recurred in 21 (21.2%) patients. The 5-year disease-free survival (DFS) and overall survival (OS) in the entire cohort were 79.2% and 81.3%, respectively. In multivariate analysis, only residual disease following initial surgery was found to be significantly associated with DFS and OS in patients with ovarian YST (p = 0.026 and p = 0.001, respectively).

CONCLUSIONS:

Our results demonstrate the significance of achieving no visible residual disease in patients with ovarian YST. Fertility-sparing approach for patients with no visible residual disease affected neither DFS nor OS. Although high lymphatic involvement rate was detected, the benefit of LND could not be demonstrated.

KEYWORDS:

Endodermal sinus tumors; Germ cell tumors; Ovarian cancer; Residual disease; Yolk sac tumors

PMID:
30982145
DOI:
10.1007/s00404-019-05160-6

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