EXPERIENCE WITH THE MANAGEMENT OF OVARIAN GERM-CELL TUMORS IN CHINESEPATIENTS

Treatment results of 37 consecutive patients with primary ovarian germ cell tumors (OGCTs) were analyzed. Thirty-three were referred after i nitial laparotomy and four were first seen at relapse. Four patients w ith stage I dysgerminoma and grade 1 immature teratoma were observed a fter operation without recurrence. There was also no relapse in eight patients with dysgerminoma given postoperative irradiation (whole abdo men, median 30 Gy). Twenty-five patients (3 dysgerminomas, 11 immature teratomas, 9 endodermal sinus tumors, and 2 mixed germ cell tumors) r eceived short-term cis-platinum-based chemotherapy. Six out of eight m easurable tumors treated by chemotherapy had complete remission. Compl ete follow-up information was obtained in 35 out of 37 patients. The 4 -year actuarial survival rates of the whole group and those referred i mmediately after initial surgery were 94.1 and 100%, respectively. cis -Platinum was substituted by carboplatin in eight cases but this did n ot affect treatment result. Nonetheless, deaths occurred in two of fou r patients referred at relapse with extensive disease and initially tr eated with suboptimal regimens. Chemotherapy-induced side effects were common but mostly tolerable and were related to cis-platinum and bleo mycin. The results of this series show that cis-platinum-based chemoth erapy is so effective that nearly 100% cure can be achieved in OGCTs a nd suggest that it is important to institute optimal chemotherapy from the start. On the other hand, common side effects of treatment and po ssible late toxicities make it desirable for future studies to see whe ther chemotherapy intensity could be reduced in patients with good pro gnosis. (C) 1994 Academic Press, Inc.