Clinical review of 55 cases of malignant ovarian germ cell tumors.
OBJECTIVE
A retrospective analysis of 55 cases of malignant germ cell tumors in a 20-year period was done to evaluate the impact of conservative surgery and adjuvant treatment on survival and fertility.


METHODS
Fifty-five cases of malignant ovarian germ cell tumors (MOGCTs) were studied. Mean age was 22 years. Dysgerminoma was the most common histotype (45%).


RESULTS
Thirty-nine patients (71%) presented with FIGO surgical Stage I disease. Fertility-sparing surgery was performed in 39 (71%) women. Postoperative systemic chemotherapy was administered to 40 women (73%), 27 (68%) had received conservative treatment. One woman developed renal failure after the first cycle of chemotherapy and died a few days thereafter and there was one case of bleomycin-induced death due to pulmonary fibrosis. There were eight (14.5%) clinical recurrences. Overall survival rate for relapsing women was 75% (6/8). The recurrence rate for women treated conservatively was 15%, and it was 13% for those treated radically. With a median follow-up of 129 months the overall survival rate for the entire study-population was 90.9%. Eleven pregnancies occurred in 36 women treated with fertility-sparing surgery who were of child-bearing age.


CONCLUSIONS
The management of MOGCTs with fertility-sparing surgery is a safe, practicable treatment option. The majority of these patients can retain normal ovarian function and reproductive potential after chemotherapy treatment.
Zanagnolo
V
V
Department of Obstetrics/Gynecology, University of Brescia, Brescia, Italy.
Sartori
E
E
Galleri
G
G
Pasinetti
B
B
Bianchi
U
U
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D005260:Female; D018237:Germinoma / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology; D007407:Interviews as Topic; D007558:Italy / Q000453:epidemiology; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D016019:Survival Analysis