Outcome and reproductive function after chemotherapy for ovarian dysgerminoma

Purpose: To review the outcome far all patients with ovarian dysgerminoma t reated at the M.D. Anderson Cancer Center who received bleomycin, etoposide , and cisplatin (BEP) and to assess the menstrual and reproductive function of those who received conservative treatment. Patients and Methods: Clinical information war abstracted from the medical record, patients completed a detailed questionnaire about menstrual and rep roductive function; those who did not return the questionnaire were intervi ewed by telephone. Results: Twenty-six patients were identified at having been treated with 88 9 chemotherapy far pure ovarian dysgerminoma from January 1984 to January 1 998, Their median age was 19.5 years (range, 7 to 32 years). Sixteen patien ts underwent fertility-sparing surgery in the form of unilateral salpingo-o ophorectomy. At a median follow-up time of 89 months, 25 (96%) of the 26 pa tients remained continuously disease-free. One patient apparently developed a second primary dysgerminoma in her remaining ovary after 889 and was cli nically disease-free after further treatment. Of the 16 patients who underw ent fertility-sparing surgery, one war lost to follow-up when she was pregn ant, and one was still premenarchal, Of the remaining 14 patients, 10 (71%) maintained their normal menstrual function during and after chemotherapy, and 13 (93%] had returned to their prechemotherapy menstrual pattern at the time of the questionnaire. Five pregnancies have occurred thus far, and tw o patients have had difficulty conceiving. Conclusion: Most patients with metastatic dysgerminoma can expect cure with maintenance of normal reproductive function when treated with conservative surgery and 889 chemotherapy. (C) 1999 by American Society of Clinical Onc ology.