Childhood malignant ovarian germ cell tumors: A monoinstitutional experience

Objectives. We reviewed our 23-year monoinstitutional exprience with childh ood malignant ovarian germ cell tumors (MOGCT), with respect to survival an d iatrogenic sequelae. Methods. Twenty-nine patients (median age 12 years) with newly diagnosed MO GCT were treated: all girls but 2 underwent surgery as initial treatment. T here were 9 pure dysgerminomas and 20 nondysgerminoma tumors (5 immature te ratomas, 4 yolk sac tumors, and 11 mixed histology tumors). According to th e FIGO classification, 9 girls were classified as stage I, 4 as II, 11 as I II, and 3 as IV, and 2 were not evaluable because they were submitted to pr imary chemotherapy. Twenty-four received chemotherapy with VAC, PVB, or FEB regimens, according to the ongoing protocols through the years. Three stag e I girls did not receive adjuvant chemotherapy because of their histology (2 dysgerminomas, 1 immature teratoma) and stage. In the early years, posto perative radiotherapy was given alone in advanced dysgerminoma stages. Results. Five patients died of their disease: 2 dysgerminomas (stage IIIc a nd IV) and 3 nondysgerminomas (2 stage II and 1 stage IIIc). OS and EFS rat es at a median of 112 months were 81.8%. Among 24 survivors, 4 experienced iatrogenic amenorrhea because of radiotherapy andlor bilateral oophorectomy . Conclusions. MOGCT are highly chemosensitive and curable, with preservation of reproductive function. The management of recurrent disease remains an o pen issue. (C) 2001 Academic Press.