G549(P) A fifteen-year review of paediatric ovarian immature teratoma and its management (2002–2017)

Autor: MJ Murray, JC Nicholson, SA Trotter
Rok vydání: 2019
Předmět:
Zdroj: BRITISH SOCIETY OF HAEMATOLOGY AND UK CHILDREN’S CANCER AND LEUKAEMIA CARE.
DOI: 10.1136/archdischild-2019-rcpch.532
Popis: Aims Paediatric ovarian immature teratoma (IT) is a rare tumour, considered largely benign in its behaviour. Surgery alone is the standard therapy regardless of stage (S; I-IV) or grade (G; 1–3); in contrast, adult women with the disease are reportedly managed with post-operative chemotherapy for all tumours except SI, G1 disease. To assess the efficacy of surgery alone in paediatric cases, the presentation and long-term outcomes were evaluated for patients aged Methods The summary diagnoses on the Paediatric Oncology departmental database identified 57 ovarian lesions, 2002–2017; histopathology records described ovarian IT in 11/57 cases. We determined clinico-pathological parameters and evaluated associations with event-free survival (defining ‘event’ as recurrence of IT, the associated phenomenon of gliomatosis peritonei, or death). Results At presentation, 8/11 patients had abdominal/pelvic pain; 6/11 raised AFP (mean 184.6 kU/L) and 5/8 raised CA-125 (mean 127.8 U/ml) serum markers. All patients received CT or MR imaging and in 10/11 cases tumour size was recorded. All cases were discussed by at least one MDT (paediatric/gynaecological oncology). Fertility-preserving surgery (avoiding bilateral oophorectomy) was performed in all cases. In nine cases where histological measurements were reported, resection by the more extensive salpingo-oophorectomy (n=5) rather than oophorectomy alone (n=4) correlated with increased histological tumour size [median tumour volume 2162 vs. 921 cm3; p=0.04 (two-tailed paired t-test)]. Four patients had seven total further events; all four had G2/G3 primary tumours. Chemotherapy was trialled in 2/4 patients; in both cases, disease progression had occurred by interim imaging and surgical control was subsequently achieved. Subsequent events did not influence overall survival, which was 100% (median follow-up 41mo; range 13–152mo). Conclusion Overall survival was 100%, regardless of subsequent events. Events were all ultimately managed surgically, including both cases of disease progression on chemotherapy. All first subsequent events occurred within 15 months of the primary diagnosis, indicating potential for step-down of follow-up beyond this timepoint. No events occurred in G1 tumours (0/3), supporting the surveillance-only strategy being pursued in the current AGCT1531 trial for paediatric and adult patients with SI, G1 disease.
Databáze: OpenAIRE
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