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      Reproductive and oncologic outcomes in women with non-epithelial ovarian cancer: Single center experience over 25 years

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          Abstract

          Objective:

          This study aimed to present our single-center clinical experience regarding tumor clinicopathologic features, treatment modalities, and reproductive and oncologic outcomes in patients with non-epithelial ovarian cancer (NEOC) over 25 years.

          Materials and Methods:

          A total of 100 patients with clinicopathological diagnosis of NEOC who were treated at our tertiary care center between 1996 and 2022 were included in this retrospective cohort analysis study. Data on demographic, clinical and obstetric characteristics of patients at the time of initial diagnosis as well as tumor clinicopathologic features, treatment modalities, and oncological and reproductive outcomes were recorded.

          Results:

          NEOCs involved germ cell tumors (GCTs) in 46 (46%) patients and sex cordstromal tumors (SCSTs) in 54 (54%) patients. Thirty patients with GCTs and thirty-four patients with SCSTs possessed histological subtypes with malignant features. Most patients with GCTs (37%) and SCSTs (55.6%) had FIGO Stage 1 disease at the time of initial diagnosis. Overall, 76.6% of patients in the GCT group (n=23) underwent fertility-sparing surgery (FSS), while 76.5% of the patients in the SCST group (n=26) were treated with non-fertility-sparing surgical procedures. All patients who underwent FSS and had a recurrence in their follow-up (n=4) was stage 3 patients. Seven out of 10 patients (2 patients at stage 3 and 5 patients at stage 1) who desired pregnancy delivered between 38 and 40 gestational weeks without any congenital anomaly. The prognosis was excellent in both groups, with 5-year overall survival (OS) rates of 93.5% in GCTs and 96.3% in SCST groups. The 5-year disease-free survival was 89.1% in GCTs and 94.4% in SCSTs. FSS was not associated with worse oncologic outcomes.

          Conclusion:

          NEOCs usually have a good prognosis because they are detected at an early stage. FSS may be indicated for women of reproductive age with early-stage NEOCs.

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          Most cited references51

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          Cancer statistics, 2022

          Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes. Incidence data (through 2018) were collected by the Surveillance, Epidemiology, and End Results program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2019) were collected by the National Center for Health Statistics. In 2022, 1,918,030 new cancer cases and 609,360 cancer deaths are projected to occur in the United States, including approximately 350 deaths per day from lung cancer, the leading cause of cancer death. Incidence during 2014 through 2018 continued a slow increase for female breast cancer (by 0.5% annually) and remained stable for prostate cancer, despite a 4% to 6% annual increase for advanced disease since 2011. Consequently, the proportion of prostate cancer diagnosed at a distant stage increased from 3.9% to 8.2% over the past decade. In contrast, lung cancer incidence continued to decline steeply for advanced disease while rates for localized-stage increased suddenly by 4.5% annually, contributing to gains both in the proportion of localized-stage diagnoses (from 17% in 2004 to 28% in 2018) and 3-year relative survival (from 21% to 31%). Mortality patterns reflect incidence trends, with declines accelerating for lung cancer, slowing for breast cancer, and stabilizing for prostate cancer. In summary, progress has stagnated for breast and prostate cancers but strengthened for lung cancer, coinciding with changes in medical practice related to cancer screening and/or treatment. More targeted cancer control interventions and investment in improved early detection and treatment would facilitate reductions in cancer mortality.
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            Burden and centralised treatment in Europe of rare tumours: results of RARECAREnet—a population-based study

            Rare cancers pose challenges for diagnosis, treatments, and clinical decision making. Information about rare cancers is scant. The RARECARE project defined rare cancers as those with an annual incidence of less than six per 100 000 people in European Union (EU). We updated the estimates of the burden of rare cancers in Europe, their time trends in incidence and survival, and provide information about centralisation of treatments in seven European countries.
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              Cancer of the ovary, fallopian tube, and peritoneum

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                Author and article information

                Journal
                Turk J Obstet Gynecol
                Turk J Obstet Gynecol
                TJOG
                Turkish Journal of Obstetrics and Gynecology
                Galenos Publishing
                2149-9322
                2149-9330
                June 2023
                1 June 2023
                : 20
                : 2
                : 97-104
                Affiliations
                [1 ]Akdeniz University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Antalya, Turkey
                Author notes
                * Address for Correspondence: Akdeniz University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Antalya, Turkey Phone: +90 532 450 09 44 E-mail: drsalihasagnic@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0002-5440-2940
                https://orcid.org/0000-0002-9557-0932
                https://orcid.org/0000-0002-5434-1025
                https://orcid.org/0000-0002-4019-5581
                https://orcid.org/0000-0003-1088-3970
                Article
                60452
                10.4274/tjod.galenos.2023.98036
                10236224
                37260166
                63e0bed7-643e-40d3-aa3b-e74830f2a194
                ©Copyright 2023 by Turkish Society of Obstetrics and Gynecology | Turkish Journal of Obstetrics and Gynecology published by Galenos Publishing House.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 February 2023
                : 28 April 2023
                Categories
                Clinical Investigation

                disease-free survival,fertility,non-epithelial ovarian tumor,prognosis

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