Nonepithelial ovarian cancers constitute about 10 % of all ovarian cancers. They are divided into sex-cord stromal tumours (SCST) and germ cell tumours (GCT). The Aim is to report the experience at National Centre for Cancer Care and Research (NCCCR) in Qatar.
This is a retrospective study reviewing records of all patients who presented with a histopathologically diagnosed ovarian SCST and GCT at NCCCR between January 2010 and December 2016. Clinical data including age, stage at diagnosis, histopathology, treatment modalities, disease recurrence and status at last follow up was extracted.
A Total of 25 women with Non Epithelial Ovarian Tumours were identified. 13 women were diagnosed with Ovarian SCST. 12 had granulosa cell tumour , 1 with steroid cell tumour and none of them had Sertoli-Leydig cell tumor. Median age at presentation was 43 years (Range 16-58). 12 patients (92 %) had stage I and 1 patient (8 %) had Stage III. 9 patients had TAH + BSO . 4 patients had conservative surgery without hysterectomy. 2 patients received Adjuvant chemotherapy .4 patients had recurrence. The 5 years Overall Survival (OS) was 100% and the 5 years Event Free Survival (EFS) was 69% with P value of 0.02.
GCT was diagnosed in 12 women. The median age at presentation was 24 years (Range 16 – 44). 7 patients (59 %) had teratoma, 4 patients (33 %) had Dysgerminoma and 1 patient had Yolk sac tumour (8 %). 9 patients ( 75 % ) had Stage 1, 2 patients had Stage 2 ( 17 % ) and 1 patient ( 8 % ) had Stage 4 disease .6 patients ( 50 % ) underwent U/L Oopherectomy .5 patients ( 42 % ) underwent U/L salpingoOopherctomy and Chemotherapy( BEP ) .1 pt. ( 8 % ) with Stage IV disease received only chemotherapy. There was 1 recurrence in the Retroperitoneal LNs in patient with Stage 2 disease. 5 years OS was 100 % and 5 years EFS was 83 % with P value of 0.14.
Survival in our study of SCST was excellent with all patients alive and disease free at last follow up. We recommend Complete Surgery (TAH + BSO) particularly if high grade, Stage 1C and above or completed child bearing to minimize recurrence.
GCTs have very good prognosis in all stages and even in recurrence. Fertility Sparing Surgery is appropriate for all patients with Stage 1 and most of patients with Stage 2 disease who desire fertility preservation.