Essential Site Maintenance: Authorea-powered sites will be updated circa 15:00-17:00 Eastern on Tuesday 5 November.
There should be no interruption to normal services, but please contact us at [email protected] in case you face any issues.

loading page

LESSONS FROM A LARGE NATIONWIDE STUDY OF 350 CHILDREN WITH OVARIAN MATURE TERATOMA: A PLEA FOR OVARIAN-SPARING SURGERY
  • +27
  • Fanny Delehaye,
  • Sabine SARNACKI ,
  • Daniel Orbach,
  • Alaa Cheikhelard,
  • Jérémie Rouger,
  • Jean-Jacques Parienti,
  • Cécile Faure-Conter,
  • Frédéric Hameury,
  • Frédérique Dijoud,
  • Estelle Aubry,
  • Agnès Wacrenier,
  • Edouard Habonimana,
  • Camille Duchesne,
  • Solène Joseph,
  • Hortense Alliot,
  • Aurélien Scalabre,
  • Yann Chaussy,
  • Guillaume Podevin,
  • Anne Croué,
  • Elodie Haraux,
  • Isabelle Pommepuy,
  • Quentin Ballouhey,
  • Frederic Lavrand,
  • Matthieu Peycelon,
  • Sabine Irtan,
  • Florent Guérin,
  • Claude Borionne,
  • Anne Dariel,
  • Louise Roulland,
  • Julien Rod
Fanny Delehaye
CHU Caen

Corresponding Author:[email protected]

Author Profile
Sabine SARNACKI
Necker-Enfants Malades Hospitals
Author Profile
Daniel Orbach
Institut Curie
Author Profile
Alaa Cheikhelard
Necker-Enfants Malades Hospitals
Author Profile
Jérémie Rouger
CHU Caen
Author Profile
Jean-Jacques Parienti
CHU Caen
Author Profile
Cécile Faure-Conter
IHOPe
Author Profile
Frédéric Hameury
CHU Lyon
Author Profile
Frédérique Dijoud
Hospices Civils de Lyon
Author Profile
Estelle Aubry
CHU Lille Pôle Enfant
Author Profile
Agnès Wacrenier
CHU Lille
Author Profile
Edouard Habonimana
CHU Rennes
Author Profile
Camille Duchesne
CHU Rennes
Author Profile
Solène Joseph
CHU Nantes
Author Profile
Hortense Alliot
CHU Nantes
Author Profile
Aurélien Scalabre
CHU Saint-Étienne
Author Profile
Yann Chaussy
CHU Besancon
Author Profile
Guillaume Podevin
CHU Angers
Author Profile
Anne Croué
CHU Angers
Author Profile
Elodie Haraux
CHU Amiens-Picardie
Author Profile
Isabelle Pommepuy
CHU Dupuytren
Author Profile
Quentin Ballouhey
CHU Limoges
Author Profile
Frederic Lavrand
CHU Bordeaux GH Pellegrin
Author Profile
Matthieu Peycelon
Robert-Debré Mother-Child University Hospital
Author Profile
Sabine Irtan
Armand-Trousseau Childrens Hospital
Author Profile
Florent Guérin
Hôpital Bicêtre
Author Profile
Claude Borionne
CHU Timone
Author Profile
Anne Dariel
CHU Timone
Author Profile
Louise Roulland
CHU Nantes
Author Profile
Julien Rod
CHU Caen
Author Profile

Abstract

Objective Ovarian mature teratoma (OMT) is a common ovarian tumor found in the pediatric population. In 10% to 20% of cases, OMT occurs as multiple synchronous or metachronous lesions on ipsi- or contralateral ovaries. Ovarian sparing surgery (OSS) is recommended to preserve fertility, but total oophorectomy (TO) is still performed. This study reviews the clinical data of patients with OMT, and analyzes risk factors for second events. Design A retrospective review of all girls under 18 years of age with OMTs was performed. Data on clinical features, imaging, laboratory studies, surgical reports, follow-up second events and their management were retrieved. Results Overall, 350 children were identified. Eighteen patients (5%) presented with a synchronous bilateral form at diagnosis. Surgery was performed by laparotomy (85%) and laparoscopy (15%). OSS and TO were performed in 59% and 41% of cases respectively. Perioperative tumor rupture occurred in 23 cases, independently of the surgical approach. Twenty-nine second events occurred (8.3%) in a median time of 30.5 months from diagnosis (ipsilateral: 8 cases including one malignant tumor, contralateral: 18 cases, both ovaries: 3 cases). A large palpable mass, bilateral forms at diagnosis and perioperative rupture had a statistical impact on the risk of second event, whereas type of surgery or approach did not. Conclusion This study is a plea in favor of OSS as the first choice of treatment of OMT when possible. Close follow-up during the first five years is mandatory considering the risk of 8.3% of second events especially in cases with risk factors.