title: Childhood malignant ovarian germ cell tumors: a monoinstitutional experience.
abstract: OBJECTIVE
  We reviewed our 23-year monoinstitutional exprience with childhood malignant ovarian germ cell tumors (MOGCT), with respect to survival and iatrogenic sequelae.
  
  
  METHODS
  Twenty-nine patients (median age 12 years) with newly diagnosed MOGCT were treated: all girls but 2 underwent surgery as initial treatment. There were 9 pure dysgerminomas and 20 nondysgerminoma tumors (5 immature teratomas, 4 yolk sac tumors, and 11 mixed histology tumors). According to the FIGO classification, 9 girls were classified as stage I, 4 as II, 11 as III, and 3 as IV, and 2 were not evaluable because they were submitted to primary chemotherapy. Twenty-four received chemotherapy with VAC, PVB, or PEB regimens, according to the ongoing protocols through the years. Three stage I girls did not receive adjuvant chemotherapy because of their histology (2 dysgerminomas, 1 immature teratoma) and stage. In the early years, postoperative radiotherapy was given alone in advanced dysgerminoma stages.
  
  
  RESULTS
  Five patients died of their disease: 2 dysgerminomas (stage IIIc and IV) and 3 nondysgerminomas (2 stage II and 1 stage IIIc). OS and EFS rates at a median of 112 months were 81.8%. Among 24 survivors, 4 experienced iatrogenic amenorrhea because of radiotherapy and/or bilateral oophorectomy.
  
  
  CONCLUSIONS
  MOGCT are highly chemosensitive and curable, with preservation of reproductive function. The management of recurrent disease remains an open issue.
authors.affiliation: Pediatric Oncology Unit, Istituto Nazionale Tumori, Milan, 20133, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Terenziani
authors.forename: M
authors.initials: M
authors.lastname: Massimino
authors.forename: M
authors.initials: M
authors.lastname: Casanova
authors.forename: G
authors.initials: G
authors.lastname: Cefalo
authors.forename: A
authors.initials: A
authors.lastname: Ferrari
authors.forename: R
authors.initials: R
authors.lastname: Luksch
authors.forename: F
authors.initials: F
authors.lastname: Spreafico
authors.forename: D
authors.initials: D
authors.lastname: Polastri
authors.forename: R
authors.initials: R
authors.lastname: Fontanelli
authors.forename: L
authors.initials: L
authors.lastname: Piva
authors.forename: F
authors.initials: F
authors.lastname: Fossati-Bellani
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D018237:Germinoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery / Q000628:therapy*