Gehad Ahmed, Sahar Ahmed Khalil, Maged Elshafiey, Nihal Abdelfattah, Mohamed Eid, Al-Shaimaa Zakaria, Madeeha Elwakeel, Ahmed Elgendy
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Based on COG staging, there were 28 patients (87.5%) stage I, 1 (3%) stage II, and 3 (9.5%) stage III. According to Norris classification, 16 patients (50%) were classified as grade I, 9 (28%) grade II, and 7 (22%) grade III. All patients in stage I were treated using surgery-alone approach, whereas the remaining four (12.5%) received adjuvant chemotherapy. Five patients in stage I had gliomatosis peritonei (GP), and none of them underwent extensive surgery. At a median follow-up of 86 months, two patients had events. The first patient (stage III/grade I) developed IT relapse on the operative bed, and the second (stage I/grade I) had a metachronous IT on the contralateral ovary. Both patients were successfully managed with surgery followed by second-line chemotherapy. 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引用次数: 0
摘要
目的：我们在埃及开展了一项关于小儿卵巢未成熟畸胎瘤（ITs）的研究：我们在埃及开展了一项关于小儿卵巢未成熟畸胎瘤（ITs）的研究，旨在明确我们的治疗策略选择：方法：对2008年至2023年间在我院接受治疗的所有纯卵巢畸胎瘤患儿进行回顾性研究。分析内容包括临床特征、根据儿童肿瘤组织（COG）进行的肿瘤分期、根据诺里斯系统进行的分级、管理和结果：共纳入32名患者，中位年龄为9岁。所有患者均接受了初级手术。31名患者接受了单侧输卵管切除术。所有患者均完成了手术分期。根据COG分期，28例患者（87.5%）为I期，1例（3%）为II期，3例（9.5%）为III期。根据诺里斯分类法，16 名患者（50%）被划分为 I 期，9 名（28%）为 II 期，7 名（22%）为 III 期。所有 I 期患者都接受了单纯手术治疗，其余 4 名患者（12.5%）接受了辅助化疗。I期患者中有5人患有腹膜胶质瘤病（GP），但他们都没有接受大范围手术。在中位 86 个月的随访中，有两名患者发生了病变。第一位患者（III期/I级）在手术床上出现了IT复发，第二位患者（I期/I级）在对侧卵巢出现了IT并发症。两名患者均成功接受了手术治疗和二线化疗。所有患者的五年总生存率和无事件生存率分别为100%和93.4%：结论：无论诺里斯分级如何，也无论是否存在GP，单纯手术治疗策略加上密切随访都能为儿童卵巢局部ITs带来极佳的疗效。然而，对于肿瘤未完全切除或局部晚期的患者，辅助化疗还存在疑问，其作用需要通过样本量更大的前瞻性多中心研究来进一步评估。
Management strategy for children with ovarian immature teratoma: results from a tertiary pediatric oncology center.
Objectives: We present an Egyptian study on pediatric ovarian immature teratomas (ITs), aiming to clarify our treatment strategy selection.
Methods: A retrospective review of all children with pure ovarian ITs who were treated at our institution between 2008 and 2023. The analysis included clinical characteristics, tumor staging according to Children's Oncology Group (COG), grading based on the Norris system, management, and outcomes.
Results: Thirty-two patients were included, with a median age of 9 years. All patients underwent primary surgery. Unilateral salpingo-oophorectomy was performed in 31 patients. Surgical staging was completed in all patients. Based on COG staging, there were 28 patients (87.5%) stage I, 1 (3%) stage II, and 3 (9.5%) stage III. According to Norris classification, 16 patients (50%) were classified as grade I, 9 (28%) grade II, and 7 (22%) grade III. All patients in stage I were treated using surgery-alone approach, whereas the remaining four (12.5%) received adjuvant chemotherapy. Five patients in stage I had gliomatosis peritonei (GP), and none of them underwent extensive surgery. At a median follow-up of 86 months, two patients had events. The first patient (stage III/grade I) developed IT relapse on the operative bed, and the second (stage I/grade I) had a metachronous IT on the contralateral ovary. Both patients were successfully managed with surgery followed by second-line chemotherapy. Five-year overall survival and event-free survival for all patients were 100% and 93.4%, respectively.
Conclusions: Surgery-alone strategy with close follow-up achieves excellent outcomes for localized ovarian ITs in children, irrespective of the Norris grading or the presence of GP. However, adjuvant chemotherapy is questionable for patients with incompletely resected or locally advanced tumors, and its role requires further evaluation through prospective multicentric studies with a larger sample size.
期刊介绍：
World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics.
Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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