Pure dysgerminoma of the ovary: a review of 45 well staged cases

Purpose: To evaluate the significance of meticulous surgical staging, and w hether type of initial surgery or adjuvant therapy impacted on survival in cases of pure ovarian dysgerminoma. Methods: Retrospective chart review of 45 patients treated for pure ovarian dysgerminoma at a single institute. Survival analysis with the Kaplan Meie r and log rank test and the chi-square test for the comparison of categoric al variables were used. Results: Of the 45 patients subjected to a surgical staging procedure 30 (6 7%) had stage I disease, 2 (4%) had stage II, 9 (20%) had stage III, and 4 (9%) had stage IV pure ovarian dysgerminoma. Thirteen of these 45 patients were referred to have seemingly stage I disease. Restaging within 2 months proved stage IIIC disease in 3 (23%) of them. With a median follow-up of 61 months, the overall survival rate for ovarian dysgerminoma in this series was 84%. Significantly lower survival rates were found in patients with adv anced stage (stage III-IV) ovarian dysgerminoma (53.9%), when compared with earlier stages (96.9%). Twenty-one patients with unilateral disease and fe rtility desire were treated with conservative surgery, 19 patients with non conservative surgery, and in 5 suboptimal debulking could be carried out. A s regards recurrence or survival rate, no significant difference was found between patients who were treated conservatively or nonconservatively, whet her or not adjuvant chemotherapy or radiotherapy was given. Of the 21 patie nts treated with conservative surgery, 11 (52%) achieved one or more pregna ncies. Conclusion: After careful surgical staging and confirming unilateral diseas e, conservative surgery, followed if necessary by adjuvant chemotherapy, se ems to be the ideal treatment in cases of pure ovarian dysgerminoma.