title: Conundrums in the management of malignant ovarian germ cell tumors: Toward lessening acute morbidity and late effects of treatment.
abstract: One of the most extraordinary stories in the chronicles of gynecologic cancers has been that of malignant ovarian germ cell tumors. Prior to the mid-1960s, most patients died of disease. Fifty years later, most survive. Precisely because high cure rates are achievable, the concentration over the past decade has been on minimizing toxicity and late effects. The present review focuses on five areas of interest related to the management of malignant ovarian germ cell tumors that highlight the different therapeutic strategies practiced by pediatric and gynecologic oncologists: 1) primary surgery, 2) surgery alone (surveillance) for patients with FIGO stage IA disease, 3) postoperative management of FIGO stage IC-III disease, 4) postoperative management of pure immature teratoma, and 5) postoperative management of metastatic pure dysgerminoma. All of these topics share a common overarching theme: Lessening acute morbidity and late effects of treatment.
authors: Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Unit 1362, 1155 Pressler Drive, Houston, TX 77030, USA. Electronic address: dgershen@mdanderson.org.
authors: David M
authors: DM
authors: Gershenson
authors: Dana-Farber/Boston Children's Cancer Center, 450 Brookline Avenue, Boston, MA 02215, USA.
authors: A Lindsay
authors: AL
authors: Frazier
mesh_terms: D003131:Combined Modality Therapy; D004407:Dysgerminoma / Q000628:therapy; D005260:Female; D006801:Humans; D009017:Morbidity; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D013724:Teratoma / Q000628:therapy
keywords: Chemotherapy; Malignant ovarian germ cell tumors; Surgical staging