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LESSONS FROM A LARGE NATIONWIDE STUDY OF 350 CHILDREN WITH OVARIAN MATURE TERATOMA: A PLEA FOR OVARIAN-SPARING SURGERY
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  • Fanny Delehaye,
  • Sabine SARNACKI ,
  • Daniel Orbach,
  • Alaa Cheikhelard,
  • Jérémie Rouger,
  • Jean-Jacques Parienti,
  • Cécile Faure-Conter,
  • Frédéric Hameury,
  • Frédérique Dijoud,
  • Estelle Aubry,
  • Agnès Wacrenier,
  • Edouard Habonimana,
  • Camille Duchesne,
  • Solène Joseph,
  • Hortense Alliot,
  • Aurélien Scalabre,
  • Yann Chaussy,
  • Guillaume Podevin,
  • Anne Croué,
  • Elodie Haraux,
  • Isabelle Pommepuy,
  • Quentin Ballouhey,
  • Frederic Lavrand,
  • Matthieu Peycelon,
  • Sabine Irtan,
  • Florent Guérin,
  • Claude Borionne,
  • Anne Dariel,
  • Louise Roulland,
  • Julien Rod
Fanny Delehaye
CHU Caen

Corresponding Author:f.delehaye@gmail.com

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Sabine SARNACKI
Necker-Enfants Malades Hospitals
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Daniel Orbach
Institut Curie
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Alaa Cheikhelard
Necker-Enfants Malades Hospitals
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Jérémie Rouger
CHU Caen
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Jean-Jacques Parienti
CHU Caen
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Cécile Faure-Conter
IHOPe
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Frédéric Hameury
CHU Lyon
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Frédérique Dijoud
Hospices Civils de Lyon
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Estelle Aubry
CHU Lille Pôle Enfant
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Agnès Wacrenier
CHU Lille
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Edouard Habonimana
CHU Rennes
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Camille Duchesne
CHU Rennes
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Solène Joseph
CHU Nantes
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Hortense Alliot
CHU Nantes
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Aurélien Scalabre
CHU Saint-Étienne
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Yann Chaussy
CHU Besancon
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Guillaume Podevin
CHU Angers
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Anne Croué
CHU Angers
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Elodie Haraux
CHU Amiens-Picardie
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Isabelle Pommepuy
CHU Dupuytren
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Quentin Ballouhey
CHU Limoges
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Frederic Lavrand
CHU Bordeaux GH Pellegrin
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Matthieu Peycelon
Robert-Debré Mother-Child University Hospital
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Sabine Irtan
Armand-Trousseau Childrens Hospital
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Florent Guérin
Hôpital Bicêtre
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Claude Borionne
CHU Timone
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Anne Dariel
CHU Timone
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Louise Roulland
CHU Nantes
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Julien Rod
CHU Caen
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Abstract

Objective Ovarian mature teratoma (OMT) is a common ovarian tumor found in the pediatric population. In 10% to 20% of cases, OMT occurs as multiple synchronous or metachronous lesions on ipsi- or contralateral ovaries. Ovarian sparing surgery (OSS) is recommended to preserve fertility, but total oophorectomy (TO) is still performed. This study reviews the clinical data of patients with OMT, and analyzes risk factors for second events. Design A retrospective review of all girls under 18 years of age with OMTs was performed. Data on clinical features, imaging, laboratory studies, surgical reports, follow-up second events and their management were retrieved. Results Overall, 350 children were identified. Eighteen patients (5%) presented with a synchronous bilateral form at diagnosis. Surgery was performed by laparotomy (85%) and laparoscopy (15%). OSS and TO were performed in 59% and 41% of cases respectively. Perioperative tumor rupture occurred in 23 cases, independently of the surgical approach. Twenty-nine second events occurred (8.3%) in a median time of 30.5 months from diagnosis (ipsilateral: 8 cases including one malignant tumor, contralateral: 18 cases, both ovaries: 3 cases). A large palpable mass, bilateral forms at diagnosis and perioperative rupture had a statistical impact on the risk of second event, whereas type of surgery or approach did not. Conclusion This study is a plea in favor of OSS as the first choice of treatment of OMT when possible. Close follow-up during the first five years is mandatory considering the risk of 8.3% of second events especially in cases with risk factors.