title: Primary chemotherapy and the role of second-look laparotomy in non-dysgerminomatous germ cell malignancies of the ovary.
abstract: In view of the rarity of germ cell tumors of the ovary, it is not surprising that little information exists about the indications for and significance of findings at second-look laparotomy in patients with these tumors. For this reason, we have reviewed 16 patients who received primary chemotherapy for malignant germ cell tumors of the ovary at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1976 and 1983. Eleven of them underwent a second-look laparotomy after completion of their therapy. Primary therapy consisted of surgery, usually unilateral oophorectomy, and cis-platinum-based VAB chemotherapy. The histologic diagnoses were six immature teratomas, five endodermal sinus tumors, four mixed germ cell tumors, and one nongestational choriocarcinoma. Stage distribution was as follows: Stage IA, eight patients; Stage IC, one patient; Stage IIA, one patient; Stage III, four patients, and unstaged, two patients. The ages ranged from 15 to 56 years, with the mean of 29 years. All of the 11 patients undergoing second-look laparotomy were found to be free of disease. They are alive and have been continuously free of disease from 9 to 77 months (mean 39 months). This paper discusses primary chemotherapy and the role of the second-look laparotomy and suggests its value in modifying treatment, predicting cure, and safely stopping therapy in patients with germ cell malignancies of the ovary.
authors: Department of Obstetrics and Gynecology, Oklahoma University Health Science Center, Oklahoma City 73190.
authors: C H
authors: CH
authors: Pippitt
authors: J M
authors: JM
authors: Cain
authors: T B
authors: TB
authors: Hakes
authors: V K
authors: VK
authors: Pierce
authors: J L
authors: JL
authors: Lewis
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002699:Chlorambucil / Q000008:administration & dosage; D002822:Choriocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D012086:Reoperation; D013724:Teratoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D002699:Chlorambucil; D003609:Dactinomycin; D014747:Vinblastine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin