Oncology and Reproductive Outcomes Over Sixteen Years of Malignant Ovarian Germ Cell Tumors Treated with Fertility Sparing Surgery

Background: Malignant Ovarian Germ Cell Tumors (MOGCT) are rare and frequently occur in the young reproductive age and the oncologic and reproductive outcome after Fertility-Sparing Surgery (FSS) this disease is still limited. Objective: To evaluate the oncology and reproductive outcome of MOGCT who underwent FSS. Method: All MOGCT who underwent FSS defined as the operation with a preserved uterus and at least one side of the ovary at our institute between January 2005 and December 2020 were retrospective reviews. Results: Sixty-two patients were recruited in this study. The median age was 22-year-old and over 77% were nulliparity. The three most common histology findings were immature teratoma (32.2%), dysgerminoma (24.2%), and yolk sac tumor (24.2%). The distribution of stage was as follows; stage I = 74.8%, stage II = 9.7%, stage III = 11.3% and stage IV = 4.8%. Forty-three (67.7%) patients received adjuvant chemotherapy. With a median follow-up time of 96.3 months, the ten-year progression-free survival and overall survival were 82.4% and 91%, respectively. For reproductive outcomes, 43 patients who received adjuvant chemotherapy, 18 (41.9%) had normal menstruation, and 17 cases (39.5%) resumed menstruation with a median time of four months. About 14 patients who desired to conceive, four cases were pregnant and delivered good outcomes. Only one case was aborted. Therefore, the successful pregnancy rate was 28.6%. Conclusion: The oncology and reproductive outcome of MOGCT treated with FSS were excellent. Many patients showed a long survival time with normal menstruation. However, the obstetric outcome was not quite high.