Examination of the usefulness of fertility-sparing surgery for pediatric
ovarian teratoma
Abstract
[Background] Ovarian teratomas are the most common ovarian tumors in
children. Fertility-sparing surgery (FSS) is often recommended owing to
its advantage of fertility preservation. We examined the validity of FSS
in pediatric patients with ovarian teratomas. [Procedure] We
retrospectively reviewed the medical records of patients who underwent
initial surgery for ovarian teratomas in our department between
1972–2021. Patients were divided into two groups: oophorectomy (OVX)
group and FSS group. Clinical characteristics, perioperative
characteristics, and outcomes were compared between the groups.
[Results] Forty-six patients underwent initial surgery (OVX: 25
patients; FSS: 21 patients). There were no differences between the
groups in terms of age, pathological diagnosis, affected side, ovarian
torsion, postoperative complications, recurrence rate, or length of
postoperative follow-up. Regarding pathological diagnosis, immature
teratomas were found only in the OVX group (p = 0.0161). The tumor size
was larger in the OVX group (p = 0.0104). Regarding perioperative
findings, operation time was longer in the FSS group (p = 0.0071) and
bleeding volume was higher in the OVX group (p = 0.0070). The number of
days until the start of oral intake and the length of hospital stay
postoperatively were shorter in the FSS group (p = 0.0002 and p
< 0.0001, respectively). [Conclusion] We demonstrated the
advantages of FSS, including its minimally invasive approach and
comparable outcomes in terms of tumor recurrence; the operation time was
longer. Since both FSS and OVX are associated with a risk of tumor
recurrence, long-term follow-up in anticipation of adult transition is
necessary.