Insights into Growing Teratoma Syndrome: An In-Depth Retrospective Analysis of Clinical Features and Treatment Outcomes

Abstract Growing teratoma syndrome (GTS) is a rare clinical condition occurring in women with malignant ovarian germ cell tumors, with paradoxical findings of normal serum tumor markers and enlarging metastatic lesions during the adjuvant chemotherapy and/or follow-up period. The appropriate management is complete surgical resection and is currently the standard of care. We aim to evaluate the surgical and oncological outcomes and follow-up of patients with GTS. A retrospective analysis of clinicopathological outcomes of patients undergoing treatment for GTS between 2014 and 2021 was conducted. Patient demographics and clinical characteristics were calculated using descriptive analysis. Survival estimates for overall survival and disease-free survival are obtained using the Kaplan-Meier method. OS and time to recurrence in GTS between two or more groups are compared using the log rank test. A two-tailed p value less than 0.05 was considered statistically significant. A total of 32 cases were included. Around 70% were stage I/II at initial diagnosis, and 60% progressed to GTS during the course of chemotherapy. Surgery was done in 27 cases. The presence of residual disease at surgery for GTS and initial stage were found to be significant predictors for overall survival and time to recurrence in GTS. GTS is a rare entity, and treatment is individualized based on several factors. A complete cytoreduction is the most important predictor for survival in these patients.