title: Ovarian germ cell malignancy: a heterogeneous tumour requiring supra-regional management.
abstract: BACKGROUND
  Malignant ovarian germ cell tumours (GCT) are rare tumours with clinical and histological heterogeneity. Risk adapted treatment of these tumours is advocated.
  
  
  METHODS
  We reviewed patients with malignant ovarian GCT managed by a single specialist during 1991-2009 at our institution. Clinicopathological features that may predict behaviour of the disease and disease outcomes were assessed.
  
  
  RESULTS
  Thirty-four patients with a median follow-up time of 5.7 years were identified. The 10-year estimated survival rates were up to 80%; 8/13 patients with Stage I disease were recommended active surveillance, of whom three relapsed and, one with an immature teratoma died.
  
  
  CONCLUSIONS
  Ovarian GCT are potentially curable but appear to have a worse prognosis than their testicular counterparts. To improve expertise in the management of these complex tumours and optimise future management, a supra-regional service modeled on that used in the management of gestational trophoblastic disease is proposed.
authors.affiliation: Clinical and Translational Oncology Unit, Hospital de Santa Maria, Lisbon, Portugal.
authors.forename: I Vaz
authors.initials: IV
authors.lastname: Luis
authors.forename: R
authors.initials: R
authors.lastname: Coleman
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D011174:Portugal; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D016387:Women's Health; D055815:Young Adult