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Ovarian mature teratomas: Differences in management and outcomes in adolescents cared for by gynecologic and pediatric surgeons
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  • Baatti Iliasse,
  • Fanny Delehaye,
  • Sabine Sarnacki,
  • Denoual Ziad Christine,
  • frederic Hameury,
  • Estelle Aubry,
  • Edouard Habonimana,
  • Solène JOSEPH,
  • Aurelien Scalabre,
  • Yann Chaussy,
  • Guillaume Podevin,
  • Ballouhey Quentin,
  • Frederic Lavrand,
  • Matthieu Peycelon,
  • Sabine Irtan,
  • Florent Guérin,
  • Anne Dariel,
  • Claude Borionne,
  • Louise Galmiche,
  • Elodie Haraux,
  • Gaichies Leopold,
  • Fauvet Raffaele,
  • julien Rod
Baatti Iliasse
Centre Hospitalier Universitaire de Caen Service de Gynecologie-Obstetrique et Medecine de la Reproduction
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Fanny Delehaye
Centre Hospitalier Universitaire de Caen Normandie

Corresponding Author:[email protected]

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Sabine Sarnacki
Hopital Universitaire Necker-Enfants Malades
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Denoual Ziad Christine
Centre Hospitalier Universitaire de Caen Service de Gynecologie-Obstetrique et Medecine de la Reproduction
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frederic Hameury
Hopital Femme Mere Enfant
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Estelle Aubry
Centre Hospitalier Universitaire de Lille Pole Enfant
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Edouard Habonimana
Centre Hospitalier Universitaire de Rennes Service de Chirurgie Pediatrique
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Solène JOSEPH
Centre Hospitalier Universitaire de Nantes
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Aurelien Scalabre
Centre Hospitalier Universitaire de Saint-Etienne
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Yann Chaussy
University Hospital of Besancon
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Guillaume Podevin
Centre Hospitalier Universitaire d'Angers
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Ballouhey Quentin
Centre Hospitalier Universitaire de Limoges
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Frederic Lavrand
Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin Hopital des Enfants
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Matthieu Peycelon
Hopital Universitaire Mere-enfant Robert-Debre
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Sabine Irtan
Hopital Armand-Trousseau Service Chirurgie Pediatrique Viscerale et Neonatale
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Florent Guérin
Assistance Publique - Hopitaux de Paris Universite Paris Saclay
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Anne Dariel
Hopital de la Timone
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Claude Borionne
Hopital de la Timone
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Louise Galmiche
Centre Hospitalier Universitaire de Nantes
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Elodie Haraux
Centre Hospitalier Universitaire Amiens-Picardie Service de Chirurgie de l'Enfant
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Gaichies Leopold
Centre Francois Baclesse Centre de Lutte Contre le Cancer
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Fauvet Raffaele
Centre Hospitalier Universitaire de Caen Service de Gynecologie-Obstetrique et Medecine de la Reproduction
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julien Rod
Centre Hospitalier Universitaire de Caen Normandie
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Abstract

Background: Ovarian mature teratomas (OMTs) are the most common benign ovarian tumors in pediatric patients. Management in adolescents can be performed by pediatric (PSs) or gynecologic surgeons (GSs). The aim of this study was to assess the differences in OMT management and the repercussions according to the risk of secondary events. Design: We compared patients aged 14 to 18 who underwent surgery for OMT between 2009 and 2022 from the French national pediatric database of OMTs with patients managed by GSs at a regional scale. Results: 119 patients were included (80 by PSs, 39 by GSs). Differences between teams were noted: (i) tumor marker analysis is systematic by PSs (80%, n = 72) but rare by GSs (18%, n = 7), (ii) PSs mostly carried out a laparotomy (78%, n = 62), whereas GSs preferred laparoscopy (90%, n = 35), (iii) per operative rupture was more frequent by GSs (56%, n = 22) than PSs (10%, n = 8), (iv) median duration of follow-up increased by PSs (20 months) versus 1 month by GSs. Ten second events (13% by GSs (n = 5), 6% by PSs (n = 5)) occurred in nine patients, without significant differences. Conclusion: A notable difference exists in the management of OMTs between PSs and GSs who may overlook a malignant component in germ cell tumors in adolescents and the risk of metachronous recurrence, however reported up to 10-20%. Compliance to SIOPE 2020 is recommended to avoid rupture of potential malignant tumor and to preserve fertility.