Non-seminomatous ovarian germ cell tumours in children

In this study, we report the results of two consecutive protocols, TGM 85 a nd TGM 90, of the Societe Francaise d'Oncologie Pediatrique (SFOP) for pati ents with non-seminomatous germ cell tumours of the ovary and analyse the r ationale for surgical indications, neoadjuvant or adjuvant chemotherapy. TG M 85 and 90 both utilised sis drugs, bleomycin, cyclophosphamide, vinblasti ne, dactinomycin, etoposide and either cisplatin (TGM 85 or carboplatin (TC M 90). Chemotherapy was given in case of unresectable or incompletely resec ted tumour. Patients who had a complete resection of a localised tumour und erwent expectant management and were only treated if progression occurred. 63 patients aged less than 18 years old were enrolled between January 1985 and December 1994, 49 patients had alpha-fetoprotein (alpha FP) +/- beta-hu man chorionic gonadotropic hormone (beta HCG) secreting tumours and 14 had immature teratomas. Median follow-up for surviving patients is 60 months (r ange: 19-154). The 5-year overall survival is 85% +/- 5%. 13 out of 14 pati ents (93%) with immature teratoma are alive, including 3 of 4 patients (75% ) who received chemotherapy for advanced disease. 41 patients (84%) with se creting tumours are alive, including 2 patients who required salvage treatm ent. Most failures occurred amongst patients with high initial alpha FP sec retion (> 15 000 ng/ml). 39 of 41 survivors (95%) in the non-teratoma group had conservative surgery, allowing the possibility of future pregnancy. Hi gh cure rate can be achieved with a conservative approach in non-seminomato us germ cell tumour of the ovary. Whenever possible, fertility should be pr eserved during the primary operation in children suffering from these tumou rs. (C) 2000 Published by Elsevier Science Ltd. All rights reserved.