A single institutional study on survival and fertility outcomes in malignant ovarian germ cell tumour patients

Malignant ovarian germ cell tumours (MOGCTs) are rare and account for 70% of malignant ovarian tumours in adolescents. Hence, fertility preservation is an important issue among this population. In this study, we aim to analyze our experience of MOGCT treatment with special emphasis on outcomes of fertility-preserving treatment and on survival outcomes.

All patients with MOGCT who underwent treatment in our institution, from January 2010 to December 2018, were included and the clinicopathologic characteristics, chemotherapy details, recurrence characteristics and follow-up data were analysed. The patients who underwent fertility-sparing surgery were contacted over the telephone to collect reproductive and menstrual outcome details.

A total of 84 patients were included in the study of which upfront surgery was followed by adjuvant chemotherapy in 44 (52.4%) patients and neoadjuvant chemotherapy was followed by interval debulking surgery and adjuvant chemotherapy in 8 patients. Fertility-sparing surgery was performed in 49 (58.3%) patients and 17 patients attempted conception and 13 (76.5%) succeeded in spontaneous pregnancy, resulting in 11 live births. All of them resumed their menstrual cycle within 1 year of treatment. With the median follow-up of 46 months, the mean 3-year disease-free survival and overall survival of 84 patients with MOGCT were 86.9% and 96.4%, respectively.

Fertility-preserving surgery with appropriate adjuvant treatment has excellent survival and fertility outcomes among patients with early as well as advanced-stage disease. Hence, it is a safe and effective option for young females with MOGCTs.