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Need for risk-adapted therapy for malignant ovarian germ cell tumors: A large multicenter analysis of germ cell tumors' patients from French TMRG network.

Authors :
Derquin F
Floquet A
Hardy-Bessard AC
Edeline J
Lotz JP
Alexandre J
Pautier P
Angeles MA
Delanoy N
Lefeuvre-Plesse C
Cancel M
Treilleux I
Augereau P
Lavoue V
Kalbacher E
Berton Rigaud D
Selle F
Nadeau C
Gantzer J
Joly F
Guillemet C
Pomel C
Favier L
Abdeddaim C
Venat-Bouvet L
Provansal M
Fabbro M
Kaminsky MC
Lortholary A
Lecuru F
Coquard IR
de La Motte Rouge T
Source :
Gynecologic oncology [Gynecol Oncol] 2020 Sep; Vol. 158 (3), pp. 666-672. Date of Electronic Publication: 2020 Jul 03.
Publication Year :
2020

Abstract

Background: Malignant ovarian germ cell tumors are rare tumors, affecting young women with a generally favorable prognosis. The French reference network for Rare Malignant Gynecological Tumors (TMRG) aims to improve their management. The purpose of this study is to report clinicopathological features and long-term outcomes, to explore prognostic parameters and to help in considering adjuvant strategy for stage I patients.<br />Patients and Methods: Data from patients with MOGCT registered among 13 of the largest centers of the TMRG network were analyzed. We report clinicopathological features, estimated 5-year event-free survival (5y-EFS) and 5-year overall survival (5y-OS) of MOGCT patients.<br />Results: We collected data from 147 patients including 101 (68.7%) FIGO stage I patients. Histology identifies 40 dysgerminomas, 52 immature teratomas, 32 yolk sac tumors, 2 choriocarcinomas and 21 mixed tumors. Surgery was performed in 140 (95.2%) patients and 106 (72.1%) received first line chemotherapy. Twenty-two stage I patients did not receive chemotherapy. Relapse occurred in 24 patients: 13 were exclusively treated with upfront surgery and 11 received surgery and chemotherapy. 5y-EFS was 82% and 5y-OS was 92.4%. Stage I patients who underwent surgery alone had an estimated 5y-EFS of 54.6% and patients receiving adjuvant chemotherapy 94.4% (P < .001). However, no impact on estimated 5y-OS was observed: 96.3% versus 97.8% respectively (P = .62). FIGO stage, complete primary surgery and post-operative alpha fetoprotein level significantly correlated with survival.<br />Conclusion: Adjuvant chemotherapy does not seem to improve survival in stage I patients. Active surveillance can be proposed for selected patients with a complete surgical staging.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1095-6859
Volume :
158
Issue :
3
Database :
MEDLINE
Journal :
Gynecologic oncology
Publication Type :
Academic Journal
Accession number :
32624235
Full Text :
https://doi.org/10.1016/j.ygyno.2020.06.491