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Updated: Jul 4, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
The influence of conservative surgical practices for malignant ovarian germ cell tumors
John K Chan1, Krishnansu S Tewari, Sarah Waller
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, UCSF Helen Diller Family, Comprehensive Cancer Center, San Francisco, California 94143-1702, USA. chanjohn@obgyn.ucsf.edu
Objective:
To evaluate demographics, survival, and surgical trends for patients with malignant ovarian germ cell tumors.
Methods:
SEER data abstracted from 1988 to 2001 and analyzed using Kaplan-Meier and Cox regression models.
Results:
Of 760 patients, the median age was 23 years. Seventy-six percent of patients presented with stage I-II disease, and 24% with stage III-IV. Fifty-five percent were immature teratomas, 32% dysgerminomas, and 13% yolk sac tumors. Fertility-preserving surgery was performed in 41.2% (n = 313) of patients. In those <45 years old, the use of fertility-preserving surgery increased from 40.5% to 44.5% to 48.4% over the time periods 1988-1992, 1993-1997, 1998-2001 (P = 0.25). The survival of patients who underwent fertility-preserving surgery was not statistically different compared to those who underwent standard surgery (P = 0.26). Patients with stage I-II disease had improved survival compared to stage III-IV disease (97.6% vs. 85.5%, P < 0.001). The overall survival of women with dysgerminomas, immature teratomas, and yolk sac tumors was 99.5%, 94.3%, and 85.4%, respectively (P < 0.001). In multivariate analysis, older age, advanced stage, and yolk sac tumor histology predicted for poorer survival.
Conclusion:
Our data suggests that the use of fertility-preserving surgery with concomitant surgical staging for germ cell cancers has increased without compromising survival.
