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Prognostic significance of an early decline in serum alpha-fetoprotein during chemotherapy for ovarian yolk sac tumors.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2016 Sep; Vol. 142 (3), pp. 452-7. Date of Electronic Publication: 2016 Jul 08. - Publication Year :
- 2016
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Abstract
- Background: The ovarian yolk sac tumor (OYST) is a very rare malignancy arising in young women. Our objective was to determine whether an early decline in serum alpha-fetoprotein (AFP) during chemotherapy has a prognostic impact.<br />Methods: This retrospective study is based on prospectively recorded OYST cases at Gustave Roussy (Cancer Treatment Center). Survival curves were estimated using the Kaplan-Meier method. The serum AFP decline was calculated with the formula previously developed and validated in male patients with poor prognosis non-seminomatous germ cell tumors. Univariate and multivariate analyses were performed using the log-rank test and logistic regression, respectively.<br />Results: Data on AFP were available to calculate an early AFP decline in 57 patients. All patients had undergone surgery followed by chemotherapy. The 5-year overall survival (OS) and event-free survival (EFS) rates were 86% (95% CI: 74%-93%) and 84% (95% CI: 73%-91%), respectively. The disease stage, presence of ascites at presentation, use of the BEP regimen, serum AFP half-life and an early AFP decline were significantly predictive factors for OS and EFS in the univariate analysis. The OS rate was 100% and 49% (95% CI: 26%-72%) in patients with a favorable AFP decline and in those with an unfavorable decline, respectively (p<0.001). In the multivariate analysis, only the presence of ascites at diagnosis (RR=7.3, p=0.03) and an unfavorable early AFP decline (RR=16.9, p<0.01) were significant negative predictive factors for OS.<br />Conclusions: An early AFP decline during chemotherapy is an independent prognostic factor in patients with OYSTs.<br />Conflict of Interest Statement: No conflict of interest.<br /> (Copyright © 2016. Published by Elsevier Inc.)
- Subjects :
- Adolescent
Adult
Endodermal Sinus Tumor pathology
Female
Humans
Middle Aged
Neoplasm Staging
Ovarian Neoplasms pathology
Prognosis
Retrospective Studies
Young Adult
Endodermal Sinus Tumor blood
Endodermal Sinus Tumor drug therapy
Ovarian Neoplasms blood
Ovarian Neoplasms drug therapy
alpha-Fetoproteins metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 142
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 27401840
- Full Text :
- https://doi.org/10.1016/j.ygyno.2016.07.005