Survival and reproductive function of 52 women treated with surgery and bleomycin, etoposide, cisplatin (BEP) chemotherapy for ovarian yolk sac tumor.
BACKGROUND
Ovarian yolk sac tumor (YST) is a very rare malignancy arising in young women. Chemotherapy has dramatically improved the prognosis. Current treatment consists of surgery followed by bleomycin, etoposide, and cisplatin (BEP) chemotherapy. However, given the rarity of this tumor, ovarian YST-specific survival and outcome after such treatment are not precisely known.


METHODS
This report concerns prospectively recorded cases that were either treated at Institut Gustave Roussy (Villejuif, France) or referred there for advice about therapy. From 1990 to 2006, 52 patients underwent surgery followed by BEP chemotherapy. Data on patient characteristics, treatment, survival, and fertility outcome were analyzed to assess treatment efficacy and gonadal toxicity after achieving a complete remission.


RESULTS
Thirty-five patients had stage I/II tumors while 17 patients presented with stage III/IV disease. With a median follow-up of 68 months, the overall 5-year survival and disease-free survival rates were 94% and 90%, respectively. Forty-one women underwent fertility-sparing surgery. Pregnancy was achieved in 12 of 16 (75%) women who attempted conception. Overall, 19 pregnancies have been recorded.


CONCLUSIONS
BEP chemotherapy following fertility-sparing surgery is a very effective treatment of ovarian YSTs. Most of the patients who attempt conception after complete remission will have children.
de La Motte Rouge
T
T
Department of Medical Oncology, Institut Gustave Roussy, Villejuif.
Pautier
P
P
Department of Medical Oncology, Institut Gustave Roussy, Villejuif.
Duvillard
P
P
Department of Biopathology, Institut Gustave Roussy, Villejuif.
Rey
A
A
Department of Biostatistics, Institut Gustave Roussy, Villejuif.
Morice
P
P
Department of Surgery, Institut Gustave Roussy, Villejuif.
Haie-Meder
C
C
Department of Radiotherapy, Institut Gustave Roussy, Villejuif.
Kerbrat
P
P
Centre Eugène Marquis, Université de Rennes 1, Rennes.
Culine
S
S
Centre Régional de Lutte Contre le Cancer Val d'Aurelle, Montpellier, France.
Troalen
F
F
Department of Biopathology, Institut Gustave Roussy, Villejuif.
Lhommé
C
C
Department of Medical Oncology, Institut Gustave Roussy, Villejuif. Electronic address: lhomme@igr.fr.
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018240:Endodermal Sinus Tumor / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005298:Fertility; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin