ahmed abu zaid (final)
Post on 14-Apr-2017
57 Views
Preview:
TRANSCRIPT
Incidence of Malignant Ovarian Germ Cell Tumors (MOGCTs) in
Saudi Arabia
Ahmed Abu-Zaid, MBBSAlfaisal University―College of Medicine
King Faisal Specialist Hospital & Research CentreRiyadh, Saudi Arabia
Hematol Oncol Stem Cell Ther. 2014 Mar;7(1):41-3
INTRODUCTION Ovarian Germ Cell Tumors (OGCT)
– Originate from primitive ovarian germ cells
– Rapidly growing tumors
– Frequent in young women and adolescent girls
– Uncommon, 20-25% of all ovarian tumors
– Pathologically: benign or malignant
Gershenson DM. Cancer. 1993;71(4 Suppl):1581-90Siegel R, et al. CA Cancer J Clin. 2013; 63:11–30
INTRODUCTION Malignant Ovarian Germ Cell Tumors (MOGCTs)
―Uncommon, 5% of all malignant ovarian tumors
―Histopathological classification
Gershenson DM. Cancer. 1993;71(4 Suppl):1581-90
Dysgerminoma Yolk Sac Tumor
Germinoma Malignant Teratoma
Polyembryoma Ovarian Choriocarcinoma
Embryonal Carcinoma Mixed Germ Cell Tumor
Siegel R, et al. CA Cancer J Clin. 2013; 63:11–30
OBJECTIVE
Define the population-based incidence and
histopathological types of MOGCTs in the Saudi
Arabian population from 1999 to 2008
MATERIALS AND METHODS Saudi Cancer Registry (SCR)
—Cross-sectional study
—Jan. 1999 to Dec. 2008
—MOGCT epidemiological data
oHistopathological types
o Frequency of cases
oCrude Incidence Rates (CIRs)
oAge-Standardized Incidence Rates (ASIRs)
SCR. https://scr.clearvision.com.saFreedman D, et al. Statistics. 1997. ISBN-10: 0393970833
RESULTS Figure 1
Incidence of Female, Ovarian and MOGCTs
All Female Tumors = 30,720
All Ovarian Tumors = 1,271Incidence = 4.1% (n= 1,271/30,720)
All MOGCTs = 175Incidence = 13.8% (n= 175/1,271)
RESULTS Figure 2
Histopathological types of MOGCTs
41%
25%
19%
14%
1%Dysgerminoma
Malignant Teratoma
Yolk Sac Tumor
Mixed Germ Cell Tumor
Embryonal Carcinoma
RESULTS Table 1
Incidence of MOGCTs per year
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Total (%)
10 7 5 5 8 4 9 8 10 6 72 (41.1)
0 0 0 2 0 0 0 0 0 0 2 (1.1)
2 2 3 6 4 4 2 1 2 6 32 (18.3)
5 7 5 5 6 3 1 2 6 4 44 (25.1)
4 2 1 1 4 2 4 4 1 2 25 (14.3)
21 (12)
18 (10.3)
14 (8.0)
19 (10.9)
22 (12.6)
13 (7.4)
16 (9.1)
15 (8.6)
19 (10.9)
18 (10.3) 175 (100)
RESULTS Table 2
Total number of cases, CIRs and world ASIRsYear All Ages 0-24 25-39 40+ CIR ASIR p1999 21 14 6 1 0.3 0.3 NS2000 18 13 3 2 0.2 0.2 NS2001 14 9 3 2 0.2 0.2 NS2002 19 13 2 4 0.2 0.2 NS2003 22 17 5 0 0.3 0.2 NS2004 13 9 2 2 0.2 0.1 NS2005 16 14 2 0 0.2 0.1 NS2006 15 10 4 1 0.2 0.2 NS2007 19 17 1 1 0.2 0.2 NS2008 18 14 5 0 0.2 0.2 NS
Total (%) 175 (100) 130 (74.3) 33 (18.9) 12 (6.9)
DISCUSSION Incidence of All Ovarian Tumors
Siegel R, et al. CA Cancer J Clin. 2013; 63: 11–30
Saudi Arabia West
All Female-Related Tumors 4.1% 3%
DISCUSSION Incidence of All MOGCTs
Saudi Arabia West Asia and Africa
13.8% 5% 15%
Low JJ, et al. Best Pract Res Clin Obstet Gynaecol. 2012; 26: 347–55
DISCUSSION Incidence of Dysgerminoma
―Most frequent histopathological type
Saudi Arabia Worldwide
All Ovarian Tumors 5.7% 2%
All MOGCTs 41.1% 35-50%
Gershenson DM. Cancer. 1993; 71: 1581–90
Chen VW, et al. Cancer. 2003; 97: 2631–42
DISCUSSION Incidence of Malignant Teratomas
―Second most frequent histopathological type
Saudi Arabia Worldwide
All Ovarian Tumors 3.5% < 1%
All MOGCTs 25.1% 20%
Deodhar KK, et al. Indian J Pathol Microbiol. 2011; 54: 730–5
DISCUSSION Incidence of Yolk Sac Tumors
―Third most frequent histopathological type
Saudi Arabia Worldwide
All MOGCTs 18.3% 20%
Gershenson DM. Cancer. 1993; 71: 1581–90
DISCUSSION Incidence of Mixed Germ Cell Tumors
―Fourth most frequent histopathological type
Saudi Arabia Worldwide
All MOGCTs 14.3% 10%
Gershenson DM. Cancer. 1993; 71: 1581–90
DISCUSSION Incidence of Polyembryoma & Primary Ovarian
Choriocarcinomas
―Mostly exist in admixed forms
Saudi Arabia Worldwide
All MOGCTs 0% < 1%
Gershenson DM. Cancer. 1993; 71: 1581–90Tewari K, et al. Obstet Gynecol. 2000; 95: 128–33
DISCUSSION Median age of MOGCTs
― 74% of cases occurred between 0 and 25 years
― Younger age group of Saudi population
― Fertility and its challenge to gynecologic oncologists
Saudi Arabia Worldwide
Median Age (years) 18 18
Williams SD, et al. Principles and practice of gynecologic oncology. 1997: 987–1002Gershenson DM. Gynecol Oncol. 1994; 55: S62–S72
STUDY LIMITATIONS
Clinico-Pathological details are not explored
― Beyond the scope of study
― Will be Addressed in a future study
CONCLUSION First Saudi study exploring incidence of MOGCTs
MOGCTs
― Common tumors (15.8%)
― Mostly in child-bearing women
― Incidence rates and histopathological types are
similar to international populations with few
differences
Future Studies Detailed Single-Center Experience at KFSH&RC
― Epidemiology/Risk factors
― Clinical Presentation
― Tumor biological behavior
― Blood markers/Imaging modalities
― Management modalities
― Prognosis
AKNOLWEDGMENT
Ahmed Nazer, MD
Osama AlOmar, MD
Ayman Azzam, MD, PhD
Haya S. Al-Eid, MD
Tusneem A. Elhassan, PhD
Ismail A. Al-Badawi, MD, FRCSC
top related