{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:21:52Z","timestamp":1789399312885,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,12,10]],"date-time":"2013-12-10T00:00:00Z","timestamp":1386633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the long\u2010term oncological and reproductive outcomes of patients aged 25 years and younger who were treated by fertility\u2010sparing cytoreductive surgery (<jats:styled-content style=\"fixed-case\">FSCS<\/jats:styled-content>) plus adjuvant chemotherapy (<jats:styled-content style=\"fixed-case\">ACT<\/jats:styled-content>) or observation alone for malignant ovarian germ cell tumors (<jats:styled-content style=\"fixed-case\">MOGCT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Records of 42 eligible female patients treated for <jats:styled-content style=\"fixed-case\">MOGCT<\/jats:styled-content> between 1 <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ay 1995 and 31 <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2010 at two centers were analyzed retrospectively. A telephone questionnaire was performed to gather reproductive and menstrual history.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One patient was treated without <jats:styled-content style=\"fixed-case\">FSCS<\/jats:styled-content> and two patients were lost to follow\u2010up. The mean age of the remaining 39 patients was 18.4\u2009\u00b1\u20093.2 years. Eighteen of the tumors were histologically pure dysgerminomas (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>) and 21 were non\u2010dysgerminomatous tumors (non\u2010<jats:styled-content style=\"fixed-case\">DT<\/jats:styled-content>). Thirteen patients (33%) presented with stage <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> disease. Optimal cytoreduction was achieved in 34 of the 39 patients (87%). Systematic pelvic and para\u2010aortic lymphadenectomy was performed in 31 of the 39 patients (79.5%). The frequency of lymph node metastasis was 29% (9\/31). Twenty\u2010seven patients (69.2%) received <jats:styled-content style=\"fixed-case\">ACT<\/jats:styled-content>. Disease recurred in six (15.3%) patients, all in the non\u2010<jats:styled-content style=\"fixed-case\">DT<\/jats:styled-content> group. Four of six underwent secondary optimal <jats:styled-content style=\"fixed-case\">FSCS<\/jats:styled-content> followed by chemotherapy. Retroperitoneal nodal recurrence was detected in two of these four patients (50%). Four deaths occurred, three due to chemoresistant aggressive disease and one due to secondary acute myelocytic leukemia. The overall survival rates for patients with <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> and non\u2010<jats:styled-content style=\"fixed-case\">DT<\/jats:styled-content> were 100% and 81.4%, respectively. Twenty\u2010three of 27 patients who received <jats:styled-content style=\"fixed-case\">ACT<\/jats:styled-content> continued their regular menses. Sixteen spontaneous pregnancies and one pregnancy by intrauterine insemination were achieved by 21 patients who attempted conception.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Either primary or secondary <jats:styled-content style=\"fixed-case\">FSCS<\/jats:styled-content> followed by <jats:styled-content style=\"fixed-case\">ACT<\/jats:styled-content> seems to be a feasible and safe approach to preserving future fertility and hormonal function in young patients with <jats:styled-content style=\"fixed-case\">MOGCT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.12253","type":"journal-article","created":{"date-parts":[[2013,12,10]],"date-time":"2013-12-10T08:37:02Z","timestamp":1386664622000},"page":"797-805","source":"Crossref","is-referenced-by-count":32,"title":["Long\u2010term oncological and reproductive outcomes of fertility\u2010sparing cytoreductive surgery in females aged 25 years and younger with malignant ovarian germ cell 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