261P - Ovarian germ cell tumours - challenges and outcomes from a tertiary care centre in South India

Background

Ovarian germ cell tumour (GCT) is a potentially curable malignancy generally occurring in young females. The impact of various social stigmas on these women is profound especially among the lower socioeconomic classes from developing countries. The data on the epidemiology and potential challenges in management will help to fine-tune our approach.

Methods

A Retrospective analysis of ovarian GCTs treated at our institute from 2011 to 2017 was carried out. Our aim was to study the epidemiology, salient features and long-term outcomes in ovarian GCTs.

Results

There were 14 benign teratomas and 35 malignant tumours. 12 were mixed GCTs ,11 were dysgerminomas, 6 were yolk sac tumours, 5 were immature teratomas and there was 1 pure Choriocarcinoma. The median age at presentation for malignant tumours was 21.14years and for benign teratomas was 40 years. Pain was the presenting complaint in 74%, mass in 20% and 5%came with ascites. Bilaterality observed in 20%dysgerminoma,14%benign teratomas and 8%mixed tumours. Those with FIGO stage1 was 58% and 38% were stage3 at presentation. Mean size of dysgerminomas was 12cm and 14cm for non-dysgerminomas. Three cases diagnosed antenatally underwent LSCS along with definitive surgery at term and another patient underwent early MTP. Fertility sparing surgery was done in 63.4% benign and 60% of malignant cases. There was no indication for chemotherapy in 6 patients. Neoadjuvant chemotherapy was given for 4 patients and adjuvant for the rest(BEP). After chemotherapy 15%developed ovarian failure. Nausea, vomiting, diarrhoea and neutropenia were the common adverse events.6 patients defaulted after surgery. All dysgerminomas and teratomas achieved complete remission and the overall rate was 93.3%. Recurrence at 45month follow-up was 18% but zero for dysgerminoma. Most recurrences were within 2years (75%). OS during the period was 88.5%.

Conclusions

Malignant ovarian GCTs occur in younger females and benign ones more in the middle age. The long-term outcomes are generally excellent. Non-dysgerminoma histology, inadequate surgery and advanced stage are poor prognostic factors. The social stigmas associated with a diagnosis of cancer seemed to adversely impact the treatment compliance and long term follow up.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The presenting author.

Funding

Has not received any funding.

All authors have declared no conflicts of interest.