Malignant ovarian germ cell tumors: identification of novel prognostic markers and long-term outcome after multimodality treatment.
OBJECTIVE
Malignant ovarian germ cell tumors are rare and knowledge about prognostic parameters currently is limited. This study was undertaken to evaluate long-term outcome of patients with malignant ovarian germ cell tumors (MOGCTs) after chemotherapy and to assess prognostic parameters.


METHODS
A total of 113 patients with stage IC to IV MOGCTs were included into this retrospective study. Patients were treated at two large regional cancer centers between 1977 and 2003.


RESULTS
Ten-year recurrence-free and overall survival rates were 82% and 81%, respectively. A total of 20 patients experienced relapse, all within the first 8 years. Outcome after relapse was poor, with only 10% of patients achieving long-term survival. Univariate and multivariate analyses demonstrated that initial stage of disease (relative risk [RR], 5.96; 95% CI, 3.47 to 10.22; P = .03) and elevation of serum markers beta-human chorionic gonadotropin and alpha-fetoprotein (RR, 3.90; 95% CI, 1.40 to 10.9; P = .009) were significant predictors of overall survival, whereas age at diagnosis was of no prognostic value.


CONCLUSIONS
This is the first study to identify stage and tumor markers as prognostic parameters for patients with MOGCTs. This might help to select patients for risk-adapted treatment. There is need for improvement of therapeutic strategies after relapse.
Murugaesu
Nirupa
N
Department of Medical Oncology, Charing Cross Hospital, London, United Kingdom.
Schmid
Peter
P
Dancey
Gairin
G
Agarwal
Roshan
R
Holden
Lydia
L
McNeish
Iain
I
Savage
Philip M
PM
Newlands
Edward S
ES
Rustin
Gordon J S
GJ
Seckl
Michael J
MJ
D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood* / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000097:blood* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis*
D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins