Patient: Description of condition (onset, main symptoms, hospital visited, etc.): I am 35 years old, had laparoscopic ovarian asexual cell tumor right adnexal resection last November, stage IA (pre-op and post-op blood CA indicators were normal), because it was a level II hospital (doctor said it was enough to do 3 times of chemotherapy, already had 3 times of chemotherapy, carboplatin + bleomycin, 3 days/time). After 3 times of chemotherapy I went to a tertiary hospital for review and the oncologist suggested me to do 4-6 times, saying that I should use carboplatin + paclitaxel or something. Also now I found another 7mm gallbladder polyp on the gallbladder, after seeing a hepatobiliary specialist, the specialist suggested to remove the gallbladder. The ovarian tumor was detected during a medical checkup, and there was no physical discomfort at that time, and now the body is recovering well. 5 years history of chronic nephritis and normal kidney function. 1.I am fertile, should I have my uterus and adnexa removed? 2.How many times of chemotherapy is considered okay and can I change the chemotherapy regimen in the middle? 3.I want to have my gallbladder removed as soon as possible, can I have laparoscopic surgery during chemotherapy? Thank you for your answer! Jie Tang, Department of Gynecology, Cancer Hospital of Fudan University: According to your condition and surgery, it is recommended to have 3-4 times of chemotherapy with BEP regimen. Laparoscopic gallbladder surgery can be performed. Patient: Hello, Dr. Tang! I was recommended to do 3 times of chemotherapy after my surgery in Punan Hospital. Based on your suggestion, I went to the oncology department of Oriental Hospital for review 21 days after the third chemotherapy (to see if I should do more chemotherapy), i.e., I was admitted to the hospital on Monday, March 12 this week. After a series of tests (I didn’t take a clear picture of the tumor marker test, which was higher than the last test result but also within the normal range), the doctor told me on Thursday that because The doctor told me on Thursday that because the hospital only did laparoscopic surgery and did not do lymphatic clearance surgery near the ovaries, I have to do 25 pelvic radiotherapy (180cgy/time, 5 times/week) + 5 weeks of heat therapy (2 times/week), and after that, 3 times of chemotherapy (the exact plan will be decided then). Dr. Tang, I would like to ask if this treatment plan is okay based on my condition. Thank you for your answer! Jie Tang, Department of Gynecology, Cancer Hospital of Fudan University: If ovarian asexual cell tumor stage IA is diagnosed after complete staging surgery (the uterus and contralateral adnexa can be preserved), then postoperative chemotherapy is not needed and regular follow-up is sufficient. This patient was operated after unilateral adnexal resection for ovarian asexual cell tumor, and complete staging surgery was not performed at the time of surgery as required for ovarian malignancy. The postoperative diagnosis of stage IA is in doubt. The remedial measures are 1. Re-operation to perfect the staging surgery steps, including contralateral ovary examination, multi-point peritoneal biopsy, retroperitoneal lymph node biopsy, etc., to determine the tumor stage after surgery. After perfect staging surgery and diagnosis of stage IA, postoperative chemotherapy is not necessary; beyond stage IA, chemotherapy is required, with a course of treatment ranging from 3-6 times; 2. Adjuvant treatment: chemotherapy, radiotherapy. Ovarian asexual cell tumor is sensitive to radiotherapy and used to be the main treatment. Nowadays, asexual cell tumors are found to be equally sensitive to chemotherapy, so the status of chemotherapy is now gradually increasing. Because of the toxic effects of radiotherapy, which can lead to loss of reproductive function, radiotherapy is generally not used as a first-line treatment option, but mostly as a remedial treatment after failure of chemotherapy. Given that the patient has already undergone surgery and 3 times of chemotherapy, it is thought that regular follow-up can be done, with checkups every 2 months for the first year to monitor tumor markers LDH, AFP, B-HCG, etc. Patient: Dr. Tang, thank you so much for your reply, I have benefited a lot from it. Thank you!