Nonepithelial malignant ovarian tumors are rare in the pediatric and adolescent population. The aim of this study was to observe the spectrum of pathology, presentation, outcome, and risk factors for survival of pediatric nonepithelial malignant ovarian tumors in a Chinese pediatric population.
Design, Setting, Participants, Interventions, and Main Outcome Measures
This was a retrospective study of 171 girls (median age at presentation of 14 years) diagnosed with primary malignant ovarian tumors between 1990 and 2014 at the Yat-Sen Memorial Hospital and Cancer Center of Sun Yat-sen University. Symptoms, pathological data, treatments, and outcomes were obtained retrospectively from the medical records.
Most (85.96%, 147/171) tumors occurred in patients aged 10-18 years and most cases were International Federation of Gynecology and Obstetrics stage I (68.42%, 117/171). The predominant pathological type was germ cell tumors (87.13%, 149/171). All patients underwent surgery, and 87 (50.88%, 87/171) underwent conservative incomplete staging surgery (unilateral salpingo-oophorectomy or tumor excision). The 5-year progression-free survival (PFS) was 59.2%. The 5-year overall survival (OS) was 88.7%. Surgical hospital (hazard ratio, 0.388; 95% confidence interval, 0.213-0.706; P = .002) was independently associated with PFS. Recurrence state (hazard ratio, 163.26; 95% confidence interval, 1.321-20,181.875; P = .038) was independently associated with OS.
Ovarian cancers in children and adolescents have features of good prognosis. Girls who received their first surgery in a tertiary hospital had better PFS. Patients who did not suffer recurrence had better OS.
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- Ovarian neoplasms in children.Arch Surg. 1993; 128 ([discussion: 853]): 849
- Malignant lesions of the ovary in childhood.Semin Pediatr Surg. 2005; 14: 100
- Evaluation of adnexal masses in adolescents.Pediatr Clin North Am. 1999; 46: 573
- Can we preoperatively risk stratify ovarian masses for malignancy?.J Pediatr Surg. 2010; 245: 130
- A retrospective review of the effect of surgeon specialty on the management of 190 benign and malignant pediatric and adolescent adnexal masses.J Pediatr Adolesc Gynecol. 2011; 24: 282
- Diagnosis and treatment of adnexal masses in children and adolescents.Obstet Gynecol. 2015; 125: 611
- A population-based analysis of 1037 malignant ovarian tumors in the pediatric population.J Surg Res. 2009; 156: 45
- Germ cell tumors of the ovary.Cancer Treat Rev. 2008; 34: 427
- Outcomes of pediatric and adolescent girls with malignant ovarian germ cell tumors.Gynecol Oncol. 2015; 137: 418
- Ovarian tumors in children and adolescents.Clin Obstet Gynecol. 1977; 20: 607
- Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer.(Version 1.2015) National Comprehensive Cancer Network, Fort Washington2015
- WHO Classification of Tumours, Pathology and Genetics: Tumours of the Breast and Female Genital Organs.IARC, Lyon2003
- New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada.J Natl Cancer Inst. 2000; 92: 205
- Cancer statistics, 2015.CA Cancer J Clin. 2015; 65: 5
- Practical Gynecologic Oncology.4th ed. Lippincott Williams & Wilkins, Philadelphia2005
- Ovarian masses in children and adolescents in China: analysis of 203 cases.J Ovarian Res. 2013; 6: 47
- Simple ultrasound-based rules for the diagnosis of ovarian cancer.Ultrasound Obstet Gynecol. 2008; 31: 681
- Malignant ovarian tumors in children: 22 years of experience at a single institution.J Pediatr Hematol Oncol. 2000; 22: 422
- Ovarian borderline mucinous tumor in a premenarchal girl: review on ovarian epithelial cancer in young girls.Gynecol Oncol. 1992; 45: 219
- Results of treatment of malignant germ cell tumors in 93 children: a report from the Childrens Cancer Study Group.J Clin Oncol. 1991; 9: 1782
- Germ cell tumors in children: gonadal and extragonadal.Med Pediatr Oncol. 1991; 19: 228
- Update on malignant ovarian germ cell tumors.Cancer. 1993; 71: 1581
- Outcome and risk factors for recurrence in malignant ovarian germ cell tumors: a MITO-9 retrospective study.Int J Gynecol Cancer. 2011; 21: 1414
Published online: October 06, 2017
The authors indicate no conflicts of interest.
© 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.