Uspješnost liječenja zloćudnih tumora podrijetla zametnog epitela jajnika

master's thesis

• Title (english): Treatment success in malignant germ-cell tumors of the ovary
• Author: Mirna Bajt
• Mentor: Goran Vujić (mentor)
• Committee member: Vesna Elveđi Gašparović (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Goran Vujić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2020-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Maligni tumori zametnih stanica ovarija (MOGCT) iznimno su rijetki, a obuhvaćaju oko 3-5% svih tumora jajnika. Javljaju se u tinejdžerica i mladih žena u dvadesetim godinama života. Iz tog je razloga očuvanje fertilnosti izuzetno važno u liječenju ovih
novotvorina. Zahvaljujući brzom rastu i ranoj pojavi simptoma uslijed distenzije kapsule jajnika, nekroze i krvarenja, MOGCT se često otkrivaju u ranim stadijima, za razliku od češćih epitelnih tumora jajnika. U posljednjih pedeset godina došlo je do velikog
napretka kirurškog i kemoterapijskog liječenja ovih tumora te su oni postali izlječivi, čak i uz očuvanje reproduktivne sposobnosti. Trenutni standard liječenja je fertility-sparing operacija (očuvanje maternice i kontralateralnog nezahvaćenog jajnika), uz temeljiti kirurški staging i adjuvantnu kombiniranu kemoterapiju po BEP protokolu (osim za disgerminom stadija IA i nezreli teratom stadija IA gradusa 1). Ipak, zbog rijetke pojave ovih tumora, mnoga su pitanja još uvijek nerazjašnjena. Po pitanju uloge radikalnog kirurškog staginga, postupka u slučaju nekompletno određenog stadija, uloge sekundarne citoreduktivne operacije u slučaju rekurentne ili progresivne bolesti, korištenja NACT u uznapredovalih MOGCT, ili pak izostavljanju kemoterapije i praćenju pacijentica sa stadijem IA MOGCT, i dalje nema konsenzusa. Ta su pitanja značajna zbog mogućnosti provođenja minimalno invazivnih zahvata i izbjegavanja štetnih kasnih učinaka kemoterapije u odabranih pacijentica.

Abstract (english)

Malignant ovarian germ cell tumors (MOGCTs) are extremely rare, and account for about 3-5% of all ovarian tumors. They affect young women in their teens and twenties. That is why fertility preservation is an important aspect of treatment for these neoplasms. Due to rapid growth and early symptoms secondary to capsular distension, necrosis and haemorrhage, tumors are often diagnosed in early stages, unlike to epithelial ovarian carcinomas. Over the last fifty years, tremendous progress in surgical and chemotherapeutic approach made those tumors curable even wih fertility preservation. The current standard treatment is fertility-sparing surgery (preservation of the uterus and unaffected ovary), along with a thorough staging procedure, followed by adjuvant combination chemotherapy with BEP protocol (except for Stage IA dysgerminoma and Stage IA Grade1 immature teratoma). Due to the rarity of this condition, there still remain a few unresolved issues,. The role of CSS, further management of incompletely staged MOGCTs, the role of secondary cytoreductive surgery in patients with recurrent or progressive disease, use of NACT in the management of advanced stage MOGCTs, and the role of surveillance in Stage IA MOGCT, remains without consensus. Those issues are of great importance for performing minimally invasive procedures and avoiding long term side efects of chemotherapy in some patients.

• Keywords: maligni tumori zametnog epitela jajnika; MOGCT; fertility-sparing operacija; citoreduktivna operacija; adjuvantna kemoterapija
• Keywords (english): malignant ovarian germ cell tumors; MOGCTs; fertility-sparing surgery; cytoreductive surgery; adjuvant chemotherapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:249162
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-30 11:06:58