title: Prognostic factors of patients with yolk sac tumors of the ovary.
abstract: OBJECTIVE
  Our purpose was to evaluate the prognostic factors in yolk sac tumors of the ovary.
  
  
  METHODS
  We performed a retrospective review of 47 patients with yolk sac tumors of the ovary from 1979 to 1997.
  
  
  RESULTS
  Twenty-two patients had pure yolk sac tumors and 25 had germ cell tumors with yolk sac tissue as a component of the disease. The 5-year survival rate in stages I, II, III, and IV was 95%, 75%, 30%, and 25%, respectively. Patients with stage I disease had a more favorable prognosis than those with stage III and IV disease (P <.001). All patients who did not respond to chemotherapy died of this disease within 36 months of the first treatment. Chemotherapy regimens that included cisplatin gave better results than those without cisplatin (P <.05). The difference in prognosis was significant in cases in which the size of residual tumor was <2 cm in diameter (P <.01) and in cases in which ascites was either absent or <100 mL in volume (P <.05). Coexistence of other components of ovarian germ cell tumors in histologic specimens, preoperative serum alpha-fetoprotein level, fertility-sparing surgery, dissection of intrapelvic nodes, and p53 status had no significant correlation with the prognosis in this study.
  
  
  CONCLUSIONS
  Staging and tumor-reductive surgery strongly affected the prognosis of this disease. Tumor-reductive surgery is advisable when ascites is minimal. Cisplatin-based chemotherapy after surgery was superior to chemotherapy without cisplatin; however, p53 status seemed to have no impact on chemosensitivity in yolk sac tumors of the ovary.
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya University School of Medicine, Japan. nawa@nyc.odn.ne.jp
authors.forename: A
authors.initials: A
authors.lastname: Nawa
authors.forename: N
authors.initials: N
authors.lastname: Obata
authors.forename: F
authors.initials: F
authors.lastname: Kikkawa
authors.forename: M
authors.initials: M
authors.lastname: Kawai
authors.forename: T
authors.initials: T
authors.lastname: Nagasaka
authors.forename: S
authors.initials: S
authors.lastname: Goto
authors.forename: K
authors.initials: K
authors.lastname: Nishimori
authors.forename: N
authors.initials: N
authors.lastname: Nakashima
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001201:Ascites / Q000378:metabolism; D002945:Cisplatin / Q000627:therapeutic use; D018240:Endodermal Sinus Tumor / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D009026:Mortality; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D002945:Cisplatin