title: Clinical and pathologic features of patients with non-epithelial ovarian cancer: retrospective analysis of a single institution 15-year experience.
abstract: OBJECTIVE
  Non-epithelial ovarian cancers (NEOCs) are rare diseases. Despite their overall good prognosis, the best management and current prognostic factors remain unclear. The objective of our study was to assess the clinical and pathological features of NEOC patients treated in our institution in the last 15 years and to explore risk factors for relapse and survival.
  
  
  METHODS
  All patients with a pathological diagnosis of NEOC referred to the medical oncology department at Hospital Universitario Virgen del Rocio between 1999 and 2014 were included. Demographics, tumor characteristics, treatment procedures, and clinical follow-up were retrospectively collected. Risk factors for disease-free survival (DFS) and overall survival (OS) were assessed.
  
  
  RESULTS
  Fifty-seven patients were included, 33 (58 %) had a sex cord-stromal tumor (SCST) and 24 (42 %) had a germ-cell tumor (GCT). Median age, non-conservative surgery rates and DFS were lower in the GCT cohort; however, salvage chemotherapy led to a high proportion of complete responses in this group translating into a 90 % 3-year OS rate in both NEOC subtypes. The only identified risk factors statistically significant were stage and tumour relapse that associated, respectively, with DFS (HR = 8.84; 95 % CI 1.85-42) and OS (HR = 11.02; 95 % CI 1.76-68.7).
  
  
  CONCLUSIONS
  Despite their rarity, NEOCs remain a highly curable group of neoplasm. In our series, a more conservative treatment approach in ovarian GCTs revealed comparable OS outcomes to SCST. No new risk factors that would help in patient stratification were identified.
authors.affiliation: Medical Oncology Department, Hospital Universitario Virgen del Rocio, Seville, Spain.|Medical Oncology Department, AP-HP, H. Mondor-A. Chenevier Hospital, Créteil, France.
authors.forename: E
authors.initials: E
authors.lastname: Kempf
authors.affiliation: Centre de Référence Maladie de Huntington, AP-HP, Hôpital H. Mondor-A. Chenevier, Créteil, France.|Inserm, U955, Equipe 01, Créteil, France.|Faculté de Médecine, Université Paris Est, Créteil, France.|Département d'Etudes Cognitives, Ecole Normale Supérieure, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Desamericq
authors.affiliation: Department of Pathology, Hospital Universitario Virgen del Rocio, Seville, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Vieites
authors.affiliation: Deanery of Doctorate Studies, School of Medicine, University of Seville, Seville, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Diaz-Padilla
authors.affiliation: Medical Oncology Department, Hospital Universitario Virgen del Rocio, Seville, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Calvo
authors.affiliation: Medical Oncology Department, Hospital Universitario Virgen del Rocio, Seville, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Estevez
authors.affiliation: Gynecology Department, Hospital Universitario Virgen del Rocio, Seville, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Arreza
authors.affiliation: Gynecology Department, Hospital Universitario Virgen del Rocio, Seville, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Martinez-Maestre
authors.affiliation: Medical Oncology Department, Hospital Universitario Virgen del Rocio, Seville, Spain. ignacioduranmartinez@gmail.com.|Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain. ignacioduranmartinez@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Duran
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Germ-cell tumors; Non-epithelial ovarian cancer; Prognostic factors; Sex-cord stromal tumors