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CC BY-NC-ND 4.0 · South Asian J Cancer 2019; 08(01): 35-40
DOI: 10.4103/sajc.sajc_6_18
ORIGINAL ARTICLE: Genitourinary Cancers

A retrospective analysis of the pattern of care and survival in patients with malignant ovarian germ cell tumors

Reshu Agarwal
Department of Gynecologic Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala
,
Anupama Rajanbabu
Department of Gynecologic Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala
,
Pavithran Keechilattu
Department of Medical Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala
,
Indu R. Nair
Department of Pathology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala
,
D. K. Vijaykumar
Department of Surgical Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala
,
U. G. Unnikrishnan
Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala
› Author Affiliations Financial support and sponsorship: Nil.
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Abstract

Objective: The objective of this study is to evaluate the pattern of care and survival outcome in patients with malignant ovarian germ cell tumors (MOGCTs). Materials and Methods: Between January 2004 and August 2017, 50 patients with MOGCT were identified at Amrita Institute of Medical Sciences and 48 included in analyses. Histologic subtypes were as follows: dysgerminoma 11; immature teratoma 16; yolk sac tumor 3; and mixed germ cell tumor 18. 31 (64.6% patients belonged to Stage I and 17 (35.4%) patients were advanced stage (Stage II-IV). Results: Median follow-up period was 34 months (range: 1–241 months). The 5- and 10-year disease-free survival (DFS) and overall survival (OS) for the entire cohort were 87.5% and 94.4%, respectively. DFS and OS of incomplete surgery Stage I patients 28.6% and 68.6%, respectively, were significantly lower than completely staged patients 100%. Out of 8 incomplete surgery patients, 5 recurred of which 2 died of disease within 4 and 9 months of recurrence. There was no survival difference with comprehensive surgical staging (CSS) and pediatric surgical staging (PSS) in Stage I MOGCT (DFS and OS 100%). Stage I dysgerminoma kept on active surveillance after PSS had equivalent survival of 100%. There was no survival difference in advanced stage MOGCT treated with primary debulking surgery and neoadjuvant chemotherapy (NAC) followed by fertility-sparing surgery (DFS and OS 100%). Conclusion: Incomplete surgery in Stage I MOGCT was associated with poor survival. There was no survival difference with CSS and PSS. NAC followed by surgery could be a reasonable option for patients of advanced stage MOGCT.

Key words

Active surveillance - comprehensive surgical staging - incomplete surgery - malignant ovarian germ cell tumor - neoadjuvant chemotherapy - pediatric surgical staging


Publication History

Article published online:
21 December 2020

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