Ahmed abu zaid (final)

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


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




DISCUSSION Incidence of Mixed Germ Cell Tumors

―Fourth most frequent histopathological type




DISCUSSION Incidence of Polyembryoma & Primary Ovarian

Choriocarcinomas

―Mostly exist in admixed forms


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


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

THANK YOU

THANK YOU

Education

Ahmed abu zaid (final)