The Evolving Spectrum of Paediatric Ovarian Malignancies From Childhood to Adulthood: A Multicentre Experience

Ovarian malignancies in children and young women exhibit distinct clinical characteristics and may be managed by either paediatric surgeons or gynaecologists, depending on patient age and institutional protocols. This multicentre retrospective study aims to evaluate similarities and differences in the management and outcomes of ovarian malignancies treated by different surgical teams.

A multicentre retrospective review was conducted, including patients who underwent surgery for ovarian malignancies from 2013 to the present. Data were collected from two paediatric surgical departments and one adult gynaecological department. Patients were categorized into two groups according to the surgical team: Group A (paediatric surgeons) and Group B (gynaecologists). Clinical, diagnostic, surgical and oncological data were analysed.

A total of 52 patients were included: 29 in Group A (median age 10 years, range 3-15) and 23 in Group B (median age 31 years, range 23-39). The most common tumour types were immature teratomas in Group A (45%) and borderline tumours in Group B (43.5%). Group A commonly underwent transabdominal ultrasound (87%) and MRI (31%), whereas Group B received transvaginal ultrasound (100%) and CT scans (78.2%). In Group A, 62% of girls underwent laparotomy, whereas 83.4% of women (Group B) underwent laparoscopy (p < 0.01). Oophorectomy was performed in 90% of cases across both groups. Patients in Group A presented more frequently with early-stage disease (93% vs. 30%, p < 0.05). During follow-up, relapse occurred in three paediatric and four adult patients, and two patients (one from each group) died due to disease progression.

Despite variations in preoperative assessment and surgical approaches, postoperative oncological treatment and long-term outcomes, including disease-free and overall survival, were comparable between the groups. Integrating the strengths of both paediatric and gynaecological approaches may further optimize the management of ovarian malignancies in young patients.