Ovarian and extragonadal malignant germ-cell tumors in females: A single-institution experience with 43 patients
| Autor: | Jose I. Mayordomo, M. T. Díaz-Puente, E. López Martín, C. Mendiola, Luis Paz-Ares, Pilar Lianes, Marta López-Brea, Fernando Rivera, Maria D. Garcia-Prats, Hernán Cortés-Funes |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Adolescent Ovariectomy Urology macromolecular substances Vinblastine Bleomycin Antineoplastic Combined Chemotherapy Protocols otorhinolaryngologic diseases Dysgerminoma Humans Medicine Radical surgery Child Survival rate Aged Etoposide Neoplasm Staging Ovarian Neoplasms Germinoma business.industry Hematology Middle Aged Endodermal sinus tumor medicine.disease Chemotherapy regimen Surgery Survival Rate carbohydrates (lipids) stomatognathic diseases Treatment Outcome Oncology Evaluation Studies as Topic bacteria Female Immature teratoma Germ cell tumors Cisplatin business Follow-Up Studies |
| Zdroj: | Annals of Oncology. 5:225-231 |
| ISSN: | 0923-7534 |
| Popis: | Summary From 1978 to 1992, 276 patients (pts) with MGCT were treated in our institution. Forty-three of the pts were female (15,5%). Median age at diagnosis was 20 years (newborn-70). Histology was dysgerminoma (D) in 14 pts (including 2 anaplastic D), endodermal sinus tumor (EST) in 9 pts, immature teratoma in 10 pts and mixed tumors in 10 pts. Primary locations were as follows: ovary (O) 33 pts and extragonadal (EG) 10 pts (pineal in 4 cases, mediastinum in 3, sacrum in 2 and pharynx in 1). Stage: I in 20 (16 0, 4 EG), U in 7 (5 O, 2 EG), IE in 12 (10 O, 2 EG) and IV in 4 (2 O, 2 EG). Serum AFP was elevated in 20/22 non-dysgerminoma pts, HCG in only 5 pts and LDH in 15/36 pts. Treatment results:Ovarian tumors all but one pt (biopsy only) underwent surgery: unilateral oophorectomy was performed in 15 pts and bilateral oophorectomy (+/− hysterectomy, + / − others) in 17 pts. Fourteen pts were rendered disease-free, 8 pts had residua] tumor (RT) ±2 cm and 11 RT >2 cm. Chemotherapy (PVB or BEP) was given to 28 pts, radiotherapy to 2 pts and no additional treatment to 3. Finally, 30 pts achieved complete response (CR) and none have relapsed at a median follow-up of 43 months. EG tumors: None of the pts underwent radical surgery. Radiotherapy was applied to 4 pineal tumors and BEP or PVB were given to all 10 pts. To date 6 pts are disease-free, 1 is alive with mature teratoma, 2 are alive with disease and 1 died of toxic effects. The projected overall survival of the series as a whole is 89% at 10 years, and it is significantly higher for pts without EST (p ± 0.02) and for pts with AFp ±1000 (p ± 0.01) and age ± 22 years at diagnosis (p ± 0.01). The projected event-free survival at 10 years is 80.4% (87.7% for ovarian rumors vs. 54% for extragonadal, p = 0.05). No events were recorded after 28 months. Conclusions The present results reflect the dramatic effectiveness of cisplatin-based chemotherapy for ovarian MGCT and confirm that unilateral oophorectomy can preserve fertility without compromising cure. Age >22 years, histology (EST) and serum AFP > 1000 ng/ml are possible prognostic factors (univariate analysis) to be tested in an independent body of data on cisplatin-treated patients. |
| Databáze: | OpenAIRE |
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