Abstract
Objective: To study the pregnancy association and malignant germ cell tumors of the ovary with
regard to its effects on tumor prognosis. Study Design:: Seventy-five patients with malignant germ cell tumors of the ovary treated at the
King Faisal Specialist Hospital-Research Center (KFSH–RC) Riyadh, Kingdom of Saudi
Arabia between January 1976 and December 1992, were reviewed. Data was retrieved from
the medical records and the database of ovarian tumor pathology. Patients with tumor/pregnancy
association were identified and correlation with obstetrical outcome and tumor prognosis
analyzed. Patients who conceived after treatment were identified and their reproductive
outcome described. Results: Malignant germ cell tumor was associated with pregnancy in a group of ten patients.
Possible tumor effects upon pregnancy in this group included operative delivery by
caesarean section (n=3), mid-trimester termination (n=2), spontaneous abortion (n=1). Four patients had normal vaginal birth with no apparent tumor effects upon pregnancy.
Pregnancy did not seem to influence the tumor prognosis of pure dysgerminoma (n=6), however, two patients with non-dysgerminomatous germ cell tumor (one endodermal
sinus tumor and one immature teratoma) died of rapidly progressive disease during
the second trimester. Two patients with advanced (stage IIIC) disease concurrent with
pregnancy (one pure dysgerminoma and one mixed germ cell tumor), had normal fetal
outcomes and achieved long-term survival. Amongst the 22 patients who planned to conceive
after conservative surgery, with or without post-operative adjuvant chemotherapy,
12 conceived (12/22) and achieved a total of 20 pregnancies. Their outcomes included
normal births (n=18) including one set of twins and hydatidiform moles (n=2). Conclusions: Our findings suggest that, (1) The association of pure dysgerminoma and pregnancy
did not adversely affect the tumor prognosis or fetal outcome. However, the question
remains as to whether pregnancy worsened the prognosis of non-dysgerminomatous germ
cell tumors. (2) Recent platinum-based regimens of multiagent chemotherapy for germ
cell tumors did not seem to affect fertility potential.
Keywords
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Article info
Publication history
Accepted:
August 12,
1999
Received in revised form:
August 3,
1999
Received:
January 4,
1999
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
