Recent management of malignant ovarian germ cell tumors: a study of 34 cases.
OBJECTIVE
To review the outcome of the treatment in patients with malignant ovarian Germ cell tumors with respect to survival and surgical management at a single institution during 1990-1996.


METHODS
Thirty-four patients with malignant ovarian Germ cell tumors were studied retrospectively for their surgical management. Fourteen patients had pure dysgerminoma, 11 endodermal sinus tumor, 6 immature teratoma, and 3 mixed Germ cell tumors. Nine patients had stage IA, 8 stage IC, 2 stage IIC, 8 stage III, 3 stage IV, and 4 referred patients with recurrent diseases.


RESULTS
Nineteen patients underwent primary conservative surgery, 11 had primary nonconservative surgery. Twenty-two patients were treated with chemotherapy (BEP or EP or PVB regimen). Five patients with pure dysgerminoma received adjuvant radiotherapy. Persistent remission was achieved in 26 patients. Two patients (7.4%) had recurrence after remission. Seven patients had died of the diseases. Patients with complete clinical remission did not undergo second-look surgery. The overall survival was 78.8%, 100% for immature teratoma, 84.6% for pure dysgerminoma, 72.8% for endodermal sinus tumor, and 33.3% for mixed Germ cell tumors, with median follow-up time 31 (3-93) months.


CONCLUSIONS
Patients with limited diseases regardless of histologic types can be safely managed by unilateral salpingo-oophorectomy followed by, if indicated, 3-4 courses of cisplatin-based chemotherapy. For advanced diseases, conservative surgery is advisable in patients with endodermal sinus tumor.
Linasmita
V
V
Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Srisupundit
S
S
Wilailak
S
S
Tangtrakul
S
S
Israngura
N
N
Bullangpoti
S
S
D000293:Adolescent; D000328:Adult; D002648:Child; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004407:Dysgerminoma / Q000601:surgery; D018240:Endodermal Sinus Tumor / Q000601:surgery; D005260:Female; D018237:Germinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D011878:Radiotherapy; D012074:Remission Induction; D012189:Retrospective Studies; D013724:Teratoma / Q000601:surgery
D002945:Cisplatin