[Clinical analysis of 57 patients with ovarian dysgerminoma].

OBJECTIVE

Ovarian dysgerminoma is an uncommen ovarian malignancy. Its clinical features are special and there are many factors influencing the prognosis. If treated properly, the patient can be cured. Otherwise it may endanger the patient's life. The aim of this study is to investigate the clinical features and factors related to prognosis of ovarian dysgerminoma.

METHODS

The data of 57 patients with pure Ovarian Dysgerminoma were analyzed retrospectively, who were admitted to Cancer Center, Sun Yat-sen University of Medical Sciences from January 1, 1964 to December 31, 2000.

RESULTS

The main clinical features were abdominal mass (56.1%), abdominal pain (21.1%), abdominal swelling(17.5%), vaginal bleeding(5.3%), genital tract abnormality (5.3%). Twenty-six patients had stage Idiseases, 8 stage II, 9 stage III, 1 stage IV and 13 recurrent and persistent diseases. The uterus was involved in 41.2% patients with stage II-III diseases. Combined modality was given to 52 cases and single-method treatment 5 cases. The overall 5-year and 10-year survival rate for stage I-IV was 80.1% and 70.0% respectively. The 5-year survival rate for stage I was 100%, stage II 55.2%, stage III 55.6%, stage IV 0% and recurrent and persistent diseases 72.7%. In the group of stage I, 12 patients received adnexectomy and 14 patients underwent hysterectomy and adnex removal, there was no significant difference between the 5-year and 10-year survival rate (all 100%) (P < 0.05). Of 23 patients in stage I group to whom only chemotherapy were given after operation, 19 cases received 3 or more courses and were well being without recurrence; four patients received only one course and one of them recurred 21 months after operation. In the group of stage II and III cases the 5-year survival rate was 86.7% for those whose chemotherapy courses were > or = 4 and 25.0% for patients who received less than 4 courses of chemotherapy (P < 0.05).

CONCLUSIONS

The prognosis of ovarian dysgerminoma is closely related to disease stage and modality of treatment. Fertility-preserving operation can be considered in early-staged patients, and be careful of doing so in middle-late staged cases. Good results can be achieved with operation-based combined modality in recurrent patients.