Salvage surgery in residual ovarian germ cell tumors
I. V. Nechushkina1,2, V.M. Nechushkina1,3, A.B. Ryabov4, A.P. Kazantsev1, P.A. Kerimov1, M.I. Nechushkin1, M.A. Rubansky1
1N.N. Blokhin National Medical Research Center of Oncology, Moscow
2Russian Medical Academy of Continuous Professional Education, Moscow
3Pirogov Russian National Research Medical University, Moscow
4National Medical Research Radiological Center, Moscow
At present, the necessity of surgical intervention for residual tumors after chemotherapy is discussed, considering the chemotherapy effects in patients with advanced or recurrent ovarian germ cell tumors. The clinical significance of such surgeries is high — they are even called the salvage surgeries, as the prognosis is poor in most cases if not to remove the residual tumors. Most researchers point to the teratoid component role in the primary tumor. Re-surgeries are indicated regardless of the malignancy severity in the primary teratoid tumor. Residual tumors complete removal is defined by the possibility of the growing teratoma syndrome development or their transformation into malignant tumors. Patients with disseminated germ cell tumors after polychemotherapy should also be included in the residual tumor removal group. Tumor removal at elevated tumor marker levels gives significantly w orse results compared to surgeries performed at normal marker levels, as the detection level of viable tumor cells increases.
Keywords: germ cell tumors, ovarian tumors, pediatric oncology, surgical treatment.
For citation: Nechushkina I.V., Nechushkina V.M., Ryabov A.B. et al. Salvage surgery in residual ovarian germ cell tumors. RMJ. Medical Review. 2019;5:35–36.
2. Culine S., Lhomme C., Michel G. et al. Is there a role for second-look laparotomy in the management of malignant germ cell tumors of the ovary? Experience at Institut Gustave Roussy. J Surg Oncol. 1996;62(1):40–45.
3. Marina N.M., Rao B., Etcubanas E. et al. The role of second-look surgery in the management of advanced germ cell malignancies. Cancer. 1991;68(2):309–315.
4. Williams S.D., Blessing J.A., DiSaia P.J. et al. Second-look laparotomy in ovarian germ cell tumors: the gynecologic oncology group experience. Gynecol Oncol. 1994; 52(3):287–291. DOI: 10.1006/gyno.1994.1050.
5. Peccatori F., Bonazzi C., Chiari S. et al. Surgical management of malignant ovarian germ cell tumors: 10 years’ experience of 129 patients. Obstet Gynecol. 1995;86(3):367–372. DOI: 10. 1016/0029-7844(95)00192-T.
6. Calver B.S., Shayegan B., Serio A. et al. Long-term clinical outcome after postchemotherapy retroperitoneal lymph node dissection in men with residual teratoma. J Clin Oncol. 2007;25(9):1033–1037. DOI: 10.1200/JCO.2005.05.4791.
7. Logothetis C.J., Samuels M.L., Trindade A., Johnson D.E. The growing teratoma syndrome. Cancer. 1982;50:1629–1635.
8. Das C.J., Sharma R., Thulkar S. et al. Mature ovarian teratoma with gliomatosis peritonei — A case report. Indian J Cancer. 2005;42(3):165–167.
9. Ferry P., de Tayrac R. Peritoneal gliomatosis. A case report and review of the literature. J Gynecol Obstet Biol Reprod. 2003;32(7):663–667.
10. Motzer R.J., Amsterdam A., Prieto V. et al. Teratoma with malignant transformation: diverse malignant histologies arising in men with germ cell tumors. J Urol. 1998;159:133–138.
11. Baniel J., Foster R.S., Gonin R. et al. Late relapse of testicular cancer. J Clin Oncol. 1995;13(5):1170–1176. DOI: 10. 1200/JCO.1995.13.5.1170.
12. Tait D., Peckham M.J., Hendry W.F., Goldstraw P. Post-chemotherapy surgery in advanced non-seminomatous germ cell testicular tumors: the significance of histology with particular reference to differentiated (mature ) teratoma. Br J Cancer. 1984;50:601–609.
13. Donohue J.P., Roth K.M., Rowland R.G. et al. Cytoreductive surgery for metastatic testis cancer: tissue analysis of retroperitoneal masses after chemotherapy. J Urol. 1982;127:1111–1114.
14. Nawa A., Obata N., Kikkawa F. et al. Prognostic factors of patients with yolk sac tumors of the ovary. Am J Obstet Gynecol. 2001;184:1182–1188. DOI: 10.1067/mob.2001.113323.
15. Wang X., Ma Z., Li Y. Ovarian yolk sac tumor: the experience of a regional cancer center. Int J Gynecol Cancer. 2016;26(5):884–891. DOI: 10. 1097/IGC. 0000000000000704.
16. Li J., Yang W., Wu X. Prognostic factors and role of salvage surgery in chemorefractory ovarian germ cell malignancies: a study in Chinese patients. Gynecol Oncol. 2007;105:769–775. DOI: 10. 1016/j.ygyno.2007.02.032.
17. Lee C.W., Song M.J., Park S.T. et al. Residual tumor after the salvage surgery is the major factors for primary treatment failure in malignant ovarian germ cell tumors: a retrospective study of single institute. W J Surg Oncol. 2011;9:123–130. DOI: 10. 1186/1477-7819-9-123.
18. Eggener S.E., Carver B.S., Loeb S. et al. Pathologic findings and clinical outcome of patients undergoing retroperitoneal lymph node dissection after multiple chemotherapy regimens for metastatic testicular germ cell tumors. Cancer. 2007;109(3):528–535. DOI: 10. 1002/cncr.22440.
19. Riggs S.B., Burgess E.F., Gaston K.E. et al. Postchemotherapy surgery for germ cell tumors — What have we learned in 35 years. The oncologist. 2014;19:498–506. DOI: 10.1634/theoncologist.2013-0379.
20. Oechsle K., Kollmannsberger C., Honecker F. et al. Long-term survival after treatment with gemcitabine and oxaliplatin with and without paclitaxel plus secondary surgery in patients with cisplatin-refractory and/or multiply relapsed germ cell tumors. Eur Urol. 2011; 60:850–855. DOI: 10.1016/j.eyruro.2011.06.019.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Распечатать