Oncologic and fertility outcome in patients with advanced stage ovarian immature teratomas

Background: Immature teratomas represent rare malignant ovarian germ cell tumours, typically involving young women. The majority of germ cell tumors (60%–70%) are diagnosed at an early stage, showing an optimal prognosis. However, advanced stages represent about one third of these patients. We report the oncologic outcome of this population, investigating also fertility outcomes in patients who underwent fertility preservation. Methods: Clinicopathological data were retrospectively collected and analysed from a cohort of 17 post-pubertal patients with advanced stage immature teratomas in a single centre between 1980 and 2024. Results: Among 17 patients included in the study, 76.5 % (13/17) underwent fertility-sparing surgery (FSS) and 23.5 % (4/17) radical surgery. Adjuvant chemotherapy was administered in 82 % (14/17) of patients. After a median follow up of 237 months (range 68.0–289.0), 2 patients had persistent disease after receiving chemotherapy and 3 showed relapse. Of these, two had a second relapse. All patients are alive without evidence of disease at the last follow up. Also 46 % (6/13) of women treated with FSS reached pregnancy. Conclusions: FSS appears to be safe and effective in the treatment of advanced stage immature teratoma. Despite surgical interventions and the administration of chemotherapy in the majority of patients, fertility outcome is satisfactory.