{"title":"Ovarian mature teratomas: Differences in management and outcomes in adolescents cared for by gynecologic and pediatric surgeons","authors":"Iliasse Baatti , Fanny Delehaye , Sabine Sarnacki , Christine Denoual Ziad , Frédéric Hameury , Estelle Aubry , Edouard Habonimana , Solène Joseph , Aurélien Scalabre , Yann Chaussy , Guillaume Podevin , Quentin Ballouhey , Frédéric Lavrand , Matthieu Peycelon , Sabine Irtan , Florent Guérin , Anne Dariel , Claude Borrione , Louise Galmiche , Elodie Haraux , Julien Rod","doi":"10.1016/j.bulcan.2025.04.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Ovarian mature teratomas (OMTs) are the most common benign ovarian tumors in pediatric patients. Management in adolescents can be performed by pediatric (PSs) or gynecologic surgeons (GSs). The aim of this study was to assess the differences in OMT management and the repercussions according to the risk of secondary events.</div></div><div><h3>Design</h3><div>Based on a multicentric study, we compared patients aged 14 to 18 who underwent surgery for OMT between 2009 and 2022 from the French national pediatric database of OMTs with patients managed by GSs.</div></div><div><h3>Results</h3><div>In total, 119 patients were included (80 by PSs, 39 by GSs). Differences between teams were noted: (i) tumor marker analysis is systematic by PSs (80%, <em>n</em> <!-->=<!--> <!-->72) but rare by GSs (18%, <em>n</em> <!-->=<!--> <!-->7) (<em>P</em> <!--><<!--> <!-->0.001), (ii) PSs mostly carried out a laparotomy (78%, <em>n</em> <!-->=<!--> <!-->62), whereas GSs preferred laparoscopy (90%, <em>n</em> <!-->=<!--> <!-->35) (<em>P</em> <!--><<!--> <!-->0.001), (iii) peroperative rupture was more frequent by GSs (56%, <em>n</em> <!-->=<!--> <!-->22) than PSs (10%, <em>n</em> <!-->=<!--> <!-->8) (<em>P</em> <!--><<!--> <!-->0.001), (iv) median duration of follow-up increased by PSs (20<!--> <!-->months) versus 1<!--> <!-->month by GSs (<em>P</em> <!-->=<!--> <!-->0.001). Ten second events (13% by GSs [<em>n</em> <!-->=<!--> <!-->5], 6% by PSs [<em>n</em> <!-->=<!--> <!-->5]) occurred in nine patients, without significant differences (<em>P</em> <!-->=<!--> <!-->0.151).</div></div><div><h3>Conclusion</h3><div>A notable difference exists in the management of OMTs between PSs and GSs in our study, GSs may overlook a malignant component in germ cell tumors in adolescents and the risk of metachronous recurrence, reported up to 10–20%. We recommend a compliance to SIOPE 2020 guidelines (Sessa et al., 2020) to avoid rupture of potential malignant tumor and to preserve fertility.</div></div>","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"112 10","pages":"Pages 1103-1112"},"PeriodicalIF":0.8000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bulletin Du Cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0007455125003339","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Ovarian mature teratomas (OMTs) are the most common benign ovarian tumors in pediatric patients. Management in adolescents can be performed by pediatric (PSs) or gynecologic surgeons (GSs). The aim of this study was to assess the differences in OMT management and the repercussions according to the risk of secondary events.
Design
Based on a multicentric study, we compared patients aged 14 to 18 who underwent surgery for OMT between 2009 and 2022 from the French national pediatric database of OMTs with patients managed by GSs.
Results
In total, 119 patients were included (80 by PSs, 39 by GSs). Differences between teams were noted: (i) tumor marker analysis is systematic by PSs (80%, n = 72) but rare by GSs (18%, n = 7) (P < 0.001), (ii) PSs mostly carried out a laparotomy (78%, n = 62), whereas GSs preferred laparoscopy (90%, n = 35) (P < 0.001), (iii) peroperative rupture was more frequent by GSs (56%, n = 22) than PSs (10%, n = 8) (P < 0.001), (iv) median duration of follow-up increased by PSs (20 months) versus 1 month by GSs (P = 0.001). Ten second events (13% by GSs [n = 5], 6% by PSs [n = 5]) occurred in nine patients, without significant differences (P = 0.151).
Conclusion
A notable difference exists in the management of OMTs between PSs and GSs in our study, GSs may overlook a malignant component in germ cell tumors in adolescents and the risk of metachronous recurrence, reported up to 10–20%. We recommend a compliance to SIOPE 2020 guidelines (Sessa et al., 2020) to avoid rupture of potential malignant tumor and to preserve fertility.
期刊介绍:
Without doubt, the ''Bulletin du Cancer'' is the French language publication of reference in the field of cancerology. Official organ of the French Society of Cancer, this journal covers all the information available, whether in the form of original articles or review articles, but also clinical cases and letters to the editor, including various disciplines as onco-hematology, solids tumors, medical oncology, pharmacology, epidemiology, biology as well as fundamental research in cancerology. The journal proposes a clinical and therapeutic approach of high scientific standard and regular updates in knowledge are thus made possible. Articles can be submitted in French or English.