Endodermal sinus tumor of the ovary: the Hacettepe University experience.
OBJECTIVE
The purpose of this study was to evaluate the treatment regimens used for patients with endodermal sinus tumors (EST), and also to examine the prognostic value of surgicopathological variables.


METHODS
Twenty-two patients treated for pure EST, and seven patients who had mixed germ cell tumors with EST components were included. Initial surgery consisting of surgical staging to achieve optimal debulking was the principal mode of therapy. Data were obtained from patients' files, a special gynecologic oncology database, and pathology records.


RESULTS
The median age at the time of diagnosis was 18 (range 8-45). Sixteen patients had stage I (55%), and 13 (45%) had stage II-IV disease. As an adjuvant therapy 18 patients (62%) received platin-based chemotherapy, three patients (10%) had non-platin-based chemotherapy, four patients (14%) had radiotherapy, and four patients (14%) had combined radiotherapy plus non-platin-based chemotherapy. The 5-year disease-free and overall survival rates were 47 and 48%, respectively. Survival rates were dismal in patients with stage II-IV disease (P < 0.001). Platin-based chemotherapy achieved significant survival benefit (P = 0.03 and P < 0.001, respectively). Fertility-saving surgery had an overall survival no worse than those who underwent more extensive surgery. There was no significant survival difference with respect to age, histology, and tumor size.


CONCLUSIONS
Fertility-sparing surgery with a postoperative platin-based combination chemotherapy should be the selected mode of treatment.
Ayhan
Ali
A
Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Kadin Hastaliklari ve Doğum A.D., Hamamönü-Ankara, Turkey. cagataytaskiran@yahoo.com
Taskiran
Cagatay
C
Bozdag
Gurkan
G
Altinbas
Sibel
S
Altinbas
Akif
A
Yuce
Kunter
K
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D018240:Endodermal Sinus Tumor / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017671:Platinum Compounds / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014421:Turkey
D000970:Antineoplastic Agents; D017671:Platinum Compounds