Pure Immature XXXX in Adults: Thirty-Year Experience of a Single Tertiary Care Center.

@entity1 @entity43 @entity5 @entity900 @entity2879 @entity1732
OBJECTIVE: The aim of this study was to evaluate clinicopathologic characteristics, treatment outcome, and reproductive function in @entity1 diagnosed with @entity43 (IT). Our standard chemotherapy regime is currently @entity2879 / @entity900 (EP), creating a unique opportunity to evaluate this protocol in ovarian ITs. MATERIALS AND METHODS: This study is a retrospective analysis. Twenty-seven @entity1 older than 18 years with @entity43 stages IA to IIIC were identified and included in this study. @entity1 were treated at 1 institution, Health Sciences Center, @entity1 's Hospital, Winnipeg, Manitoba, Canada, between 1983 and 2013. RESULTS: The median age at diagnosis was 27.0 years (range, 18-36 years). Twenty-two (82%) presented with an International Federation of Gynecology and Obstetrics stage I disease, 3 (11%) had stage II, and 2 @entity1 (7%) had @entity5 . The histologic grade distribution was grade I in 9 @entity1 (33%), grade II in 3 @entity1 (11%), and grade III in 15 @entity1 (56%). Initial management was surgical for all @entity1 : 3 (11%) hysterectomy and bilateral salpingo-oophorectomy, 1 (4%) cystectomy only, and 23 (85%) unilateral salpingo-oophorectomy. Twenty-one @entity1 (78%) received adjuvant therapy. The median follow-up was 60 months (range, 36-72 months). One @entity1 recurred (histological grade III) 6 months after surgery and had a complete clinical response to 4 cycles of EP chemotherapy. Twelve @entity1 reported an attempt to conceive resulting in 10 pregnancies (8 after chemotherapy). CONCLUSIONS: Ovarian IT is a curable disease. Fertility-sparing surgery should be offered. Adjuvant treatment with @entity900 -based chemotherapy, typically with @entity1732 , @entity2879 , and @entity900 , is still considered the standard in stages greater than stage IA grade I. @entity2879 / @entity900 as a primary chemotherapy regime for early- or advanced-stage disease is an effective treatment with minimal adverse effects and high tolerability. This is the first published study examining EP as a primary treatment modality for IT. Further studies are needed to strengthen these findings.
