Ovarian germ cell tumor surgery: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 5: | Line 5: | ||
==Overview== | ==Overview== | ||
Surgical intervention is the mainstay of management of ovarian germ cell tumors. Surgery must be done for the purpose of staging and maybe treatment according to the stage of the tumor. | [[Surgical]] [[intervention]] is the mainstay of management of [[ovarian]] [[germ cell]] [[tumors]]. [[Surgery]] must be done for the purpose of [[Cancer staging|staging]] and maybe treatment according to the stage of the tumor. | ||
Surgical management of the ovarian germ cell tumors, for the purpose of treatment, classified to two categories according to the preference of the patient to preserve the ovary or not. Surgery is the mainstay of treatment for mature teratoma. | [[Surgical]] management of the [[ovarian]] [[germ cell]] [[tumors]], for the purpose of treatment, classified to two categories according to the preference of the patient to preserve the [[ovary]] or not. [[Surgery]] is the mainstay of treatment for [[Mature cystic teratoma|mature teratoma]]. | ||
==Surgery== | ==Surgery== | ||
| Line 14: | Line 14: | ||
. http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_54. URL Accessed on Nov 5, 2015</ref><ref name="ccc">Stage IV Ovarian Germ Cell Tumors | . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_54. URL Accessed on Nov 5, 2015</ref><ref name="ccc">Stage IV Ovarian Germ Cell Tumors | ||
. http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_65. URL Accessed on Nov 5, 2015</ref> | . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_65. URL Accessed on Nov 5, 2015</ref> | ||
* [[Surgery]] is indicated for the purpose of staging and maybe treatment according to the stage of the tumor.<ref name="Gershenson2007">{{cite journal|last1=Gershenson|first1=David M.|title=Management of Ovarian Germ Cell Tumors|journal=Journal of Clinical Oncology|volume=25|issue=20|year=2007|pages=2938–2943|issn=0732-183X|doi=10.1200/JCO.2007.10.8738}}</ref> | * [[Surgery]] is [[Indication (medicine)|indicated]] for the purpose of staging and maybe treatment according to the stage of the [[tumor]].<ref name="Gershenson2007">{{cite journal|last1=Gershenson|first1=David M.|title=Management of Ovarian Germ Cell Tumors|journal=Journal of Clinical Oncology|volume=25|issue=20|year=2007|pages=2938–2943|issn=0732-183X|doi=10.1200/JCO.2007.10.8738}}</ref> | ||
* Surgical management of the ovarian germ cell tumors, for the purpose of treatment, classified to two categories according to the preference of the patient to preserve the ovary or not. | * [[Surgical]] management of the [[ovarian]] [[germ cell]] [[tumors]], for the purpose of treatment, classified to two categories according to the preference of the patient to preserve the [[ovary]] or not. | ||
===Mature teratoma=== | ===Mature teratoma=== | ||
* [[Surgery]] is the mainstay of [[treatment]] for mature teratoma.<ref name="Yayla AbideBostancı Ergen2018">{{cite journal|last1=Yayla Abide|first1=Çiğdem|last2=Bostancı Ergen|first2=Evrim|title=Retrospective analysis of mature cystic teratomas in a single center and review of the literature|journal=Journal of Turkish Society of Obstetric and Gynecology|volume=15|issue=2|year=2018|pages=95–98|issn=1307699X|doi=10.4274/tjod.86244}}</ref> | * [[Surgery]] is the mainstay of [[treatment]] for [[Mature cystic teratoma|mature teratoma]].<ref name="Yayla AbideBostancı Ergen2018">{{cite journal|last1=Yayla Abide|first1=Çiğdem|last2=Bostancı Ergen|first2=Evrim|title=Retrospective analysis of mature cystic teratomas in a single center and review of the literature|journal=Journal of Turkish Society of Obstetric and Gynecology|volume=15|issue=2|year=2018|pages=95–98|issn=1307699X|doi=10.4274/tjod.86244}}</ref> | ||
**Nonsurgical management may be considered in those with [[tumors]] smaller than 6 cm, especially those who is planning to get [[pregnant]].<ref name="CaspiAppelman1997">{{cite journal|last1=Caspi|first1=Benjamin|last2=Appelman|first2=Zvi|last3=Rabinerson|first3=David|last4=Zalel|first4=Yaron|last5=Tulandi|first5=Togas|last6=Shoham|first6=Zeev|title=The growth pattern of ovarian dermoid cysts: a prospective study in premenopausal and postmenopausal women|journal=Fertility and Sterility|volume=68|issue=3|year=1997|pages=501–505|issn=00150282|doi=10.1016/S0015-0282(97)00228-8}}</ref> | **Nonsurgical management may be considered in those with [[tumors]] smaller than 6 cm, especially those who is planning to get [[pregnant]].<ref name="CaspiAppelman1997">{{cite journal|last1=Caspi|first1=Benjamin|last2=Appelman|first2=Zvi|last3=Rabinerson|first3=David|last4=Zalel|first4=Yaron|last5=Tulandi|first5=Togas|last6=Shoham|first6=Zeev|title=The growth pattern of ovarian dermoid cysts: a prospective study in premenopausal and postmenopausal women|journal=Fertility and Sterility|volume=68|issue=3|year=1997|pages=501–505|issn=00150282|doi=10.1016/S0015-0282(97)00228-8}}</ref> | ||
***[[Surgery]] increses the risk of [[Adhesions|band adhesion]] formation that may be associated with future [[fertility]] in women. | ***[[Surgery]] increses the risk of [[Adhesions|band adhesion]] formation that may be associated with future [[fertility]] in women. | ||
===Dysgerminoma=== | ===Dysgerminoma=== | ||
* Surgery is the mainstay of treatment in dysgerminomas. Additional [[chemotherapy]] and/or [[radiotherapy]] depend on the [[stage]] of the [[tumor]].<ref name="VicusBeiner2010">{{cite journal|last1=Vicus|first1=Danielle|last2=Beiner|first2=Mario E.|last3=Klachook|first3=Shany|last4=Le|first4=Lisa W.|last5=Laframboise|first5=Stephane|last6=Mackay|first6=Helen|title=Pure dysgerminoma of the ovary 35 years on: A single institutional experience|journal=Gynecologic Oncology|volume=117|issue=1|year=2010|pages=23–26|issn=00908258|doi=10.1016/j.ygyno.2009.12.024}}</ref> | * [[Surgery]] is the mainstay of treatment in [[Dysgerminoma|dysgerminomas]]. Additional [[chemotherapy]] and/or [[radiotherapy]] depend on the [[stage]] of the [[tumor]].<ref name="VicusBeiner2010">{{cite journal|last1=Vicus|first1=Danielle|last2=Beiner|first2=Mario E.|last3=Klachook|first3=Shany|last4=Le|first4=Lisa W.|last5=Laframboise|first5=Stephane|last6=Mackay|first6=Helen|title=Pure dysgerminoma of the ovary 35 years on: A single institutional experience|journal=Gynecologic Oncology|volume=117|issue=1|year=2010|pages=23–26|issn=00908258|doi=10.1016/j.ygyno.2009.12.024}}</ref> | ||
* Stage 1A: [[fertility]]-preserving [[surgery]] without [[adjuvant]] [[chemotherapy]] or [[radiotherapy]].<ref name="AL HusainiSoudy2012">{{cite journal|last1=AL Husaini|first1=Hamed|last2=Soudy|first2=Hussein|last3=Darwish|first3=Alaa El Din|last4=Ahmed|first4=Mohamed|last5=Eltigani|first5=Amin|last6=AL Mubarak|first6=Mustafa|last7=Sabaa|first7=Amal Abu|last8=Edesa|first8=Wael|last9=AL-Tweigeri|first9=Taher|last10=Al-Badawi|first10=Ismail A.|title=Pure dysgerminoma of the ovary: a single institutional experience of 65 patients|journal=Medical Oncology|volume=29|issue=4|year=2012|pages=2944–2948|issn=1357-0560|doi=10.1007/s12032-012-0194-z}}</ref> | * Stage 1A: [[fertility]]-preserving [[surgery]] without [[adjuvant]] [[chemotherapy]] or [[radiotherapy]].<ref name="AL HusainiSoudy2012">{{cite journal|last1=AL Husaini|first1=Hamed|last2=Soudy|first2=Hussein|last3=Darwish|first3=Alaa El Din|last4=Ahmed|first4=Mohamed|last5=Eltigani|first5=Amin|last6=AL Mubarak|first6=Mustafa|last7=Sabaa|first7=Amal Abu|last8=Edesa|first8=Wael|last9=AL-Tweigeri|first9=Taher|last10=Al-Badawi|first10=Ismail A.|title=Pure dysgerminoma of the ovary: a single institutional experience of 65 patients|journal=Medical Oncology|volume=29|issue=4|year=2012|pages=2944–2948|issn=1357-0560|doi=10.1007/s12032-012-0194-z}}</ref> | ||
| Line 27: | Line 27: | ||
* Dysgerminomas | * Dysgerminomas | ||
:* Unilateral [[salpingo-oophorectomy]] with or without [[lymphangiography ]]or [[computed tomography]] (CT) | :* Unilateral [[salpingo-oophorectomy]] with or without [[lymphangiography ]]or [[computed tomography]] (CT) | ||
:* Unilateral salpingo-oophorectomy followed by observation | :* Unilateral [[salpingo-oophorectomy]] followed by observation | ||
:* Unilateral salpingo-oophorectomy with adjuvant [[radiation therapy]] or [[chemotherapy]] | :* Unilateral [[salpingo-oophorectomy]] with [[adjuvant]] [[radiation therapy]] or [[chemotherapy]] | ||
* Other germ cell tumors | * Other germ cell tumors | ||
:* Unilateral salpingo-oophorectomy with adjuvant chemotherapy | :* Unilateral [[salpingo-oophorectomy]] with [[adjuvant chemotherapy]] | ||
:* Unilateral salpingo-oophorectomy followed by observation | :* Unilateral [[salpingo-oophorectomy]] followed by observation | ||
===Stage II ovarian germ cell tumors=== | ===Stage II ovarian germ cell tumors=== | ||
* Dysgerminomas | * [[Dysgerminoma|Dysgerminomas]] | ||
:* Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant radiation therapy or chemotherapy | :* Total [[abdominal]] [[hysterectomy]] and [[bilateral]] [[salpingo-oophorectomy]] with [[adjuvant]] [[radiation]] therapy or [[chemotherapy]] | ||
:* Unilateral salpingo-oophorectomy with adjuvant chemotherapy | :* Unilateral salpingo-oophorectomy with adjuvant chemotherapy | ||
* Other germ cell tumors | * Other germ cell tumors | ||
:* Unilateral salpingo-oophorectomy with [[adjuvant chemotherapy]] | :* Unilateral [[salpingo-oophorectomy]] with [[adjuvant chemotherapy]] | ||
:* Second-look laparotomy | :* Second-look [[laparotomy]] | ||
===Stage III ovarian germ cell tumors=== | ===Stage III ovarian germ cell tumors=== | ||
* Dysgerminomas | * Dysgerminomas | ||
:* Total abdominal [[hysterectomy]] and bilateral salpingo-oophorectomy | :* Total [[abdominal]] [[hysterectomy]] and [[bilateral]] [[salpingo-oophorectomy]] | ||
:* Unilateral salpingo-oophorectomy with adjuvant chemotherapy | :* Unilateral [[salpingo-oophorectomy]] with [[adjuvant]] [[chemotherapy]] | ||
* Other germ cell tumors | * Other germ cell tumors | ||
:* Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemotherapy, with or without neoadjuvant chemotherapy | :* Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemotherapy, with or without neoadjuvant chemotherapy | ||
| Line 59: | Line 59: | ||
==Indications== | ==Indications== | ||
*[[Surgery]] is not the [[first-line treatment]] option for patients with mature teratoma. [[Surgery]] is usually reserved for patients with either:<ref name="CaspiAppelman1997">{{cite journal|last1=Caspi|first1=Benjamin|last2=Appelman|first2=Zvi|last3=Rabinerson|first3=David|last4=Zalel|first4=Yaron|last5=Tulandi|first5=Togas|last6=Shoham|first6=Zeev|title=The growth pattern of ovarian dermoid cysts: a prospective study in premenopausal and postmenopausal women|journal=Fertility and Sterility|volume=68|issue=3|year=1997|pages=501–505|issn=00150282|doi=10.1016/S0015-0282(97)00228-8}}</ref> | *[[Surgery]] is not the [[first-line treatment]] option for patients with mature teratoma. [[Surgery]] is usually reserved for patients with either:<ref name="CaspiAppelman1997">{{cite journal|last1=Caspi|first1=Benjamin|last2=Appelman|first2=Zvi|last3=Rabinerson|first3=David|last4=Zalel|first4=Yaron|last5=Tulandi|first5=Togas|last6=Shoham|first6=Zeev|title=The growth pattern of ovarian dermoid cysts: a prospective study in premenopausal and postmenopausal women|journal=Fertility and Sterility|volume=68|issue=3|year=1997|pages=501–505|issn=00150282|doi=10.1016/S0015-0282(97)00228-8}}</ref> | ||
Revision as of 14:58, 21 March 2019
|
Ovarian germ cell tumor Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Ovarian germ cell tumor surgery On the Web |
|
American Roentgen Ray Society Images of Ovarian germ cell tumor surgery |
|
Risk calculators and risk factors for Ovarian germ cell tumor surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]
Overview
Surgical intervention is the mainstay of management of ovarian germ cell tumors. Surgery must be done for the purpose of staging and maybe treatment according to the stage of the tumor. Surgical management of the ovarian germ cell tumors, for the purpose of treatment, classified to two categories according to the preference of the patient to preserve the ovary or not. Surgery is the mainstay of treatment for mature teratoma.
Surgery
- Surgery is the mainstay of management of ovrian germ cell tumors:[1][2][3][4]
- Surgery is indicated for the purpose of staging and maybe treatment according to the stage of the tumor.[5]
- Surgical management of the ovarian germ cell tumors, for the purpose of treatment, classified to two categories according to the preference of the patient to preserve the ovary or not.
Mature teratoma
- Surgery is the mainstay of treatment for mature teratoma.[6]
Dysgerminoma
- Surgery is the mainstay of treatment in dysgerminomas. Additional chemotherapy and/or radiotherapy depend on the stage of the tumor.[8]
- Stage 1A: fertility-preserving surgery without adjuvant chemotherapy or radiotherapy.[9]
Stage I ovarian germ cell tumors
- Dysgerminomas
- Unilateral salpingo-oophorectomy with or without lymphangiography or computed tomography (CT)
- Unilateral salpingo-oophorectomy followed by observation
- Unilateral salpingo-oophorectomy with adjuvant radiation therapy or chemotherapy
- Other germ cell tumors
- Unilateral salpingo-oophorectomy with adjuvant chemotherapy
- Unilateral salpingo-oophorectomy followed by observation
Stage II ovarian germ cell tumors
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant radiation therapy or chemotherapy
- Unilateral salpingo-oophorectomy with adjuvant chemotherapy
- Other germ cell tumors
- Unilateral salpingo-oophorectomy with adjuvant chemotherapy
- Second-look laparotomy
Stage III ovarian germ cell tumors
- Dysgerminomas
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy
- Unilateral salpingo-oophorectomy with adjuvant chemotherapy
- Other germ cell tumors
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemotherapy, with or without neoadjuvant chemotherapy
- Unilateral salpingo-oophorectomy with adjuvant chemotherapy, with or without neoadjuvant chemotherapy
- Second-look laparotomy
Stage IV ovarian germ cell tumors
- Dysgerminomas
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemotherapy
- Unilateral salpingo-oophorectomy with adjuvant chemotherapy
- Other germ cell tumors
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemotherapy with or without neoadjuvant chemotherapy
- Unilateral salpingo-oophorectomy with adjuvant chemotherapy with or without neoadjuvant chemotherapy
Indications
- Surgery is not the first-line treatment option for patients with mature teratoma. Surgery is usually reserved for patients with either:[7]
- Tumor size larger than 6 cm
- No plans for future pregnancy
- Post-menopausal women
Contraindications
References
- ↑ Stage I Ovarian Germ Cell Tumors . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_33. URL Accessed on Nov 5, 2015
- ↑ Stage II Ovarian Germ Cell Tumors . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_43. URL Accessed on Nov 5, 2015
- ↑ Stage III Ovarian Germ Cell Tumors . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_54. URL Accessed on Nov 5, 2015
- ↑ Stage IV Ovarian Germ Cell Tumors . http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_65. URL Accessed on Nov 5, 2015
- ↑ Gershenson, David M. (2007). "Management of Ovarian Germ Cell Tumors". Journal of Clinical Oncology. 25 (20): 2938–2943. doi:10.1200/JCO.2007.10.8738. ISSN 0732-183X.
- ↑ Yayla Abide, Çiğdem; Bostancı Ergen, Evrim (2018). "Retrospective analysis of mature cystic teratomas in a single center and review of the literature". Journal of Turkish Society of Obstetric and Gynecology. 15 (2): 95–98. doi:10.4274/tjod.86244. ISSN 1307-699X.
- ↑ 7.0 7.1 Caspi, Benjamin; Appelman, Zvi; Rabinerson, David; Zalel, Yaron; Tulandi, Togas; Shoham, Zeev (1997). "The growth pattern of ovarian dermoid cysts: a prospective study in premenopausal and postmenopausal women". Fertility and Sterility. 68 (3): 501–505. doi:10.1016/S0015-0282(97)00228-8. ISSN 0015-0282.
- ↑ Vicus, Danielle; Beiner, Mario E.; Klachook, Shany; Le, Lisa W.; Laframboise, Stephane; Mackay, Helen (2010). "Pure dysgerminoma of the ovary 35 years on: A single institutional experience". Gynecologic Oncology. 117 (1): 23–26. doi:10.1016/j.ygyno.2009.12.024. ISSN 0090-8258.
- ↑ AL Husaini, Hamed; Soudy, Hussein; Darwish, Alaa El Din; Ahmed, Mohamed; Eltigani, Amin; AL Mubarak, Mustafa; Sabaa, Amal Abu; Edesa, Wael; AL-Tweigeri, Taher; Al-Badawi, Ismail A. (2012). "Pure dysgerminoma of the ovary: a single institutional experience of 65 patients". Medical Oncology. 29 (4): 2944–2948. doi:10.1007/s12032-012-0194-z. ISSN 1357-0560.