Pure dysgerminoma of the ovary in childhood: treatment results and sequelae.
Thirty-five children with pure dysgerminoma of the ovary were all treated at the Institut Gustave Roussy (IGR) from 1956-1985. The median follow-up is 8.5 years. The crude 5-year survival rate is 94.1% (+/- 4.1). The disease-free 5-year survival rate is 81.8% (+/- 6.7). Fourteen patients who had stage I disease were treated by unilateral salpingooophorectomy and prophylactic radiotherapy (20 Gy) to ipsilateral iliac, lumbar-aortic, and subclavicular lymph nodes. All are alive without sequelae. Eighteen patients with stage II and III disease were treated by surgery and radiotherapy (30-40 Gy) to the tumor volume. All are alive but radio-induced sequelae are severe. Five relapses of stage I, II, and III tumors occurred and were cured by a second line treatment. Two of the three patients with stage IV disease died. Four patients received a cisplatinum-containing regimen for disseminated disease or because of a relapse before radiotherapy. Three achieved a complete response of measurable tumor. Given the high efficacy of this kind of chemotherapy and the severe sequelae induced by abdomino-pelvic irradiation, we propose initial chemotherapy for widespread disease and radiotherapy in the event of residual tumor.
Teinturier
C
C
Department of Pediatrics, Institut Gustave Roussy, Villejuif, France.
Gelez
J
J
Flamant
F
F
Habrand
J L
JL
Lemerle
J
J
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects; D004407:Dysgerminoma / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D016896:Treatment Outcome