Clinical significance of comprehensive staging surgery in the treatment of ovarian yolk sac tumor
Objective To investigate the clinical characteristics and prognosis associated with ovarian yolk sac tumor(OYST),and analyze the clinical significance of comprehensive staging surgery.Methods A retrospective review was conducted on the clinical data from 17 OYST patients treated at Nanjing Drum Tower Hospital between January 2004 and January 2022 to analyze the incidence patterns and prognosis of these patients.The patients who underwent lymph node dissection were taken as the observation group,and those who did not undergo lymph node dissection were taken as the control group.The intraoperative and postoperative conditions between the two groups were analyzed.Results According to the FIGO staging,11 out of 17 patients were stage Ⅰ,and the remaining 6 were stage Ⅱ～Ⅳ.All patients underwent fertility-preserving surgery,the overall 5-year survival rate is 91％.7 patients planned for fertility after the surgery,and 6 of them successfully completed pregnancies(including 1 case involving assisted reproductive technology),all resulting in full-term deliveries.Compared with the control group,the observation group had more bleeding volume[(837.50±211.51)mL vs.(211.67±75.04)mL,P=0.003],longer surgery duration[(223.75±101.19)min vs.(80.67±29.33)min,P=0.001],slower postoperative intestinal function recovery[(60.00±9.79)h vs.(40.00±9.34)h,P=0.003],and a longer interval between surgery and chemotherapy[(11.25±1.25)d vs.(6.90±1.22)d,P＜0.001].There was no difference in 1-year survival rate between the two groups(92.3％vs.100％,P=0.567).Conclusion OYST predominantly affects women of reproductive age,and fertility-preserving surgery followed by timely chemotherapy significantly enhances survival rates.The implementation of a comprehensive staging surgery,results in increased surgical trauma without difference in short-term prognosis.
ovarian yolk sac tumorprognosisfertility-sparingpelvic lymph node dissectioncomprehensive staging surgery
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