Characteristics and Outcomes of Children and Adolescents With Epithelial Ovarian Neoplasms From a Tertiary Cancer Centre in Western India: A Retrospective Study

TL;DR

This study examines the characteristics and outcomes of children and adolescents with epithelial ovarian neoplasms in western India.

Contribution

It provides a rare retrospective analysis of EON in pediatric patients from a specific region.

Findings

Malignant EONs require multimodality treatment.

Advanced disease and serous tumors are associated with poor survival.

Three-year progression-free survival was 37.5% and overall survival was 70%.

Abstract

Epithelial ovarian neoplasms (EON) are uncommon in children and data is limited. We conducted this study to assess the clinical characteristics and outcomes of children and adolescents with EON. Children ≤18 years of age diagnosed with EON, between 1st January 2010 and 31st December 2022 were included for retrospective analysis. Clinical characteristics, treatment details, and outcomes were noted. One-hundred-sixteen patients were diagnosed with ovarian mass, and eight (0.07%) of them were EON. Median age was 17 years (range: 13-18 years). One (12.5%) patient had a family history of breast cancer. One (12.5%) had borderline serous cystadenocarcinoma, four (50%) had malignant serous, and three (37.5%) had malignant mucinous adenocarcinoma. One girl with borderline disease (stage Ia) was treated with surgery and is alive. Among seven patients with malignant EONs, two (28.6%), two (28.6%), two (28.6%), and one (14.2%) had stage Ia, II, IIIc, and Iva disease, respectively. Two (28.6%) patients underwent primary debulking surgery. Two patients (28.6%) received neoadjuvant chemotherapy (NACT) followed by interval debulking. Three (42.8%) patients received chemotherapy and did not undergo surgery because of stable/progressive disease. Two patients (25%) with stage Ia were alive without evidence of disease. One girl (12.5%) with stage IIb relapsed after primary treatment and succumbed to the disease. All three patients with stage IIIc and one with stage IVa had relapse/progression, and three patients succumbed to the disease. Malignant EONs require multimodality treatment. Advanced disease and serous tumors are associated with poor survival. With a mean (± standard deviation) follow-up of 56 ± 10 months, the three-year progression-free survival (PFS) and overall survival (OS) were 37.5%±17.1% and 70%±18.2%, respectively.