Oncologic and reproductive outcomes after fertility-sparing surgery in young women with malignant ovarian germ cell tumors

Objective: This study evaluated the oncologic and obstetric outcomes after fertility-sparing surgery (FSS) in young patients with malignant ovarian germ cell tumors (MOGCTs). Methods: The medical records of women aged <= 40 years who underwent FSS for MOGCTs at our institution between July 2002 and December 2018 were retrospectively reviewed. FSS was defined as the preservation of the uterus and at least one adnexa. Results: Forty-four patients were included in this study. The median age of the patients was 22 years (range, 7-39 years). FIGO stage I (81.8%) was the most common, and stage II (6.8%), III (91%) and IV (2.3%) was also present. Twenty-nine patients (65.9%) received adjuvant chemotherapy with bleomycin, etoposide, and cisplatin (BEP) after a surgery. During a median follow-up period of 62 months (range, 7-185), four patients (9.1%) had a recurrence. Of these four patients, two with dysgerminoma had recurrences at para-aortic lymph nodes and two with immature teratomas had recurrences at the remaining ovary. Thirty-seven patients (88.1%) had regular menstruation. Of fourteen women desiring pregnancy, twelve achieved the term delivery of twelve singleton pregnancies. The pregnancy and live birth rates were 85.7% and 100%, respectively. Conclusions: FSS with or without following BEP chemotherapy is an appropriate option for young women with MOGCTs who wish to preserve their fertility.