Is adjuvant chemotherapy indicated in stage i pure immature ovarian teratoma (IT)? A multicentre Italian trial in ovarian cancer (MITO-9)

G. Mangili, G. Scarfone, A. Gadducci, C. Sigismondi, G. Ferrandina, G. Scibilia, R. Viganò, S. Tateo, A. Villa, D. Lorusso

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Abstract

Objective.: Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for stage I immature ovarian teratoma (IT), except for stage IA G1. Nevertheless the use of chemotherapy in stage IA G2-3 and IB-IC is controversial. The aim of this study was to evaluate the outcome of patients with IT in order to define the role of chemotherapy in stage I disease. Methods.: Twenty-eight patients with stage I IT treated in MITO centers were retrospectively reviewed. Grade, stage, age, surgical and postoperative treatment were analyzed using χ2 test and T test looking for association with recurrence. Results.: Median age was 25.5. Twenty-four patients underwent fertility-sparing surgery. FIGO stages were 19 IA, 2 IB, and 7 IC. Nine patients had grade 1 tumor, 12 grade 2, and 7 grade 3. Nine patients received adjuvant chemotherapy. Overall recurrence rate was 21.4% (2 in chemotherapy group and 4 in the group without treatment). No patients with G1 had recurrence, whereas 25% of G2 and 42.9% of G3 relapsed. Recurrence rate was not significantly different according to stage, grade or adjuvant chemotherapy, whereas it was greater in the group not operated in a MITO center, not staged and of age lower than 20 years, with statistical significance. At recurrence 4 patients presenting with mature teratoma were treated with surgery alone, whereas 2 recurring with IT were treated with surgery plus chemotherapy. After a median follow-up of 59 months all patients are NED. Conclusions.: Our study suggests that chemotherapy may be withheld for primary therapy and utilized only for recurrence.

Original languageEnglish
Pages (from-to)48-52
Number of pages5
JournalGynecologic Oncology
Volume119
Issue number1
DOIs
Publication statusPublished - Oct 2010

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Teratoma
Adjuvant Chemotherapy
Ovarian Neoplasms
Multicenter Studies
Recurrence
Drug Therapy
Ovarian Teratoma
Platinum
Fertility
Therapeutics

Keywords

  • Chemotherapy
  • Immature teratoma
  • Recurrence
  • Stage I
  • Surveillance

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Medicine(all)

Cite this

Is adjuvant chemotherapy indicated in stage i pure immature ovarian teratoma (IT)? A multicentre Italian trial in ovarian cancer (MITO-9). / Mangili, G.; Scarfone, G.; Gadducci, A.; Sigismondi, C.; Ferrandina, G.; Scibilia, G.; Viganò, R.; Tateo, S.; Villa, A.; Lorusso, D.

In: Gynecologic Oncology, Vol. 119, No. 1, 10.2010, p. 48-52.

Research output: Contribution to journalArticle

Mangili, G. ; Scarfone, G. ; Gadducci, A. ; Sigismondi, C. ; Ferrandina, G. ; Scibilia, G. ; Viganò, R. ; Tateo, S. ; Villa, A. ; Lorusso, D. / Is adjuvant chemotherapy indicated in stage i pure immature ovarian teratoma (IT)? A multicentre Italian trial in ovarian cancer (MITO-9). In: Gynecologic Oncology. 2010 ; Vol. 119, No. 1. pp. 48-52.
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abstract = "Objective.: Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for stage I immature ovarian teratoma (IT), except for stage IA G1. Nevertheless the use of chemotherapy in stage IA G2-3 and IB-IC is controversial. The aim of this study was to evaluate the outcome of patients with IT in order to define the role of chemotherapy in stage I disease. Methods.: Twenty-eight patients with stage I IT treated in MITO centers were retrospectively reviewed. Grade, stage, age, surgical and postoperative treatment were analyzed using χ2 test and T test looking for association with recurrence. Results.: Median age was 25.5. Twenty-four patients underwent fertility-sparing surgery. FIGO stages were 19 IA, 2 IB, and 7 IC. Nine patients had grade 1 tumor, 12 grade 2, and 7 grade 3. Nine patients received adjuvant chemotherapy. Overall recurrence rate was 21.4{\%} (2 in chemotherapy group and 4 in the group without treatment). No patients with G1 had recurrence, whereas 25{\%} of G2 and 42.9{\%} of G3 relapsed. Recurrence rate was not significantly different according to stage, grade or adjuvant chemotherapy, whereas it was greater in the group not operated in a MITO center, not staged and of age lower than 20 years, with statistical significance. At recurrence 4 patients presenting with mature teratoma were treated with surgery alone, whereas 2 recurring with IT were treated with surgery plus chemotherapy. After a median follow-up of 59 months all patients are NED. Conclusions.: Our study suggests that chemotherapy may be withheld for primary therapy and utilized only for recurrence.",
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AU - Scarfone, G.

AU - Gadducci, A.

AU - Sigismondi, C.

AU - Ferrandina, G.

AU - Scibilia, G.

AU - Viganò, R.

AU - Tateo, S.

AU - Villa, A.

AU - Lorusso, D.

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N2 - Objective.: Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for stage I immature ovarian teratoma (IT), except for stage IA G1. Nevertheless the use of chemotherapy in stage IA G2-3 and IB-IC is controversial. The aim of this study was to evaluate the outcome of patients with IT in order to define the role of chemotherapy in stage I disease. Methods.: Twenty-eight patients with stage I IT treated in MITO centers were retrospectively reviewed. Grade, stage, age, surgical and postoperative treatment were analyzed using χ2 test and T test looking for association with recurrence. Results.: Median age was 25.5. Twenty-four patients underwent fertility-sparing surgery. FIGO stages were 19 IA, 2 IB, and 7 IC. Nine patients had grade 1 tumor, 12 grade 2, and 7 grade 3. Nine patients received adjuvant chemotherapy. Overall recurrence rate was 21.4% (2 in chemotherapy group and 4 in the group without treatment). No patients with G1 had recurrence, whereas 25% of G2 and 42.9% of G3 relapsed. Recurrence rate was not significantly different according to stage, grade or adjuvant chemotherapy, whereas it was greater in the group not operated in a MITO center, not staged and of age lower than 20 years, with statistical significance. At recurrence 4 patients presenting with mature teratoma were treated with surgery alone, whereas 2 recurring with IT were treated with surgery plus chemotherapy. After a median follow-up of 59 months all patients are NED. Conclusions.: Our study suggests that chemotherapy may be withheld for primary therapy and utilized only for recurrence.

AB - Objective.: Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for stage I immature ovarian teratoma (IT), except for stage IA G1. Nevertheless the use of chemotherapy in stage IA G2-3 and IB-IC is controversial. The aim of this study was to evaluate the outcome of patients with IT in order to define the role of chemotherapy in stage I disease. Methods.: Twenty-eight patients with stage I IT treated in MITO centers were retrospectively reviewed. Grade, stage, age, surgical and postoperative treatment were analyzed using χ2 test and T test looking for association with recurrence. Results.: Median age was 25.5. Twenty-four patients underwent fertility-sparing surgery. FIGO stages were 19 IA, 2 IB, and 7 IC. Nine patients had grade 1 tumor, 12 grade 2, and 7 grade 3. Nine patients received adjuvant chemotherapy. Overall recurrence rate was 21.4% (2 in chemotherapy group and 4 in the group without treatment). No patients with G1 had recurrence, whereas 25% of G2 and 42.9% of G3 relapsed. Recurrence rate was not significantly different according to stage, grade or adjuvant chemotherapy, whereas it was greater in the group not operated in a MITO center, not staged and of age lower than 20 years, with statistical significance. At recurrence 4 patients presenting with mature teratoma were treated with surgery alone, whereas 2 recurring with IT were treated with surgery plus chemotherapy. After a median follow-up of 59 months all patients are NED. Conclusions.: Our study suggests that chemotherapy may be withheld for primary therapy and utilized only for recurrence.

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