title: Yolk sac tumor of the ovary: a retrospective multicenter study of 33 Japanese women by Tohoku Gynecologic Cancer Unit (TGCU).
abstract: Yolk sac tumor (YST) of the ovary is a rare germ cell tumor comprising about 1% of all ovarian malignancies. YST usually occurs as a rapidly growing unilateral tumor in young women. With the introduction of cisplatin, YST has been changed from a fatal tumor to a curable tumor. The standard treatment of YST consists of fertility-preserving surgery and 3 or 4 courses of adjuvant combination chemotherapy with bleomycin, etoposide, and cisplatin (BEP). However, the long-term prognosis of BEP-treated YST patients has not been well studied. We therefore conducted a retrospective multicenter study to investigate the prognostic factors of 33 YST patients, including 25 patients treated with BEP. The median age at initial treatment was 20 years (range 10-53). There were 15 patients (at stage I), one (stage II), 16 (stage III), and one (stage IV). Nominal and grouped numerical values were analyzed by the Kaplan-Meier method. All patients had unilateral tumor, with right-side predominance (23 patients; P = 0.02). Eighteen patients had pure YST, 13 had mixed germ cell tumor with YST component, and other 2 patients were not specified. Twenty-eight patients received fertility-preserving surgery. Twenty-seven patients had optimal surgery with less than 1 cm residual tumor diameter. Median number of chemotherapy courses was 5. Median follow-up period was 49 months. The cumulative 5-year survival rate was 87%. Univariate analysis revealed the following significant prognostic factors (P < 0.05): stage, tumor diameter, and residual tumor. Extensive debulking surgery to minimize residual tumor would improve the prognosis.
authors.affiliation: Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine,Yamagata, Japan. tkojimah@med.id.yamagata-u.ac.jp
authors.forename: Takanobu
authors.initials: T
authors.lastname: Kojimahara
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakahara
authors.forename: Tadao
authors.initials: T
authors.lastname: Takano
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yaegashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Keiya
authors.initials: K
authors.lastname: Fujimori
authors.forename: Naoki
authors.initials: N
authors.lastname: Sato
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Terada
authors.forename: Toru
authors.initials: T
authors.lastname: Tase
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Mizunuma
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Shoji
authors.forename: Toru
authors.initials: T
authors.lastname: Sugiyama
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kurachi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D018240:Endodermal Sinus Tumor / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006176:Gynecology; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008495:Medical Oncology; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D055815:Young Adult