TY - JOUR
T1 - Need for risk-adapted therapy for malignant ovarian germ cell tumors
T2 - A large multicenter analysis of germ cell tumors' patients from French TMRG network
AU - Derquin, F.
AU - Floquet, A.
AU - Hardy-Bessard, A. C.
AU - Edeline, J.
AU - Lotz, J. P.
AU - Alexandre, J.
AU - Pautier, P.
AU - Angeles, M. A.
AU - Delanoy, N.
AU - Lefeuvre-Plesse, C.
AU - Cancel, M.
AU - Treilleux, I.
AU - Augereau, P.
AU - Lavoue, V.
AU - Kalbacher, E.
AU - Berton Rigaud, D.
AU - Selle, F.
AU - Nadeau, C.
AU - Gantzer, J.
AU - Joly, F.
AU - Guillemet, C.
AU - Pomel, C.
AU - Favier, L.
AU - Abdeddaim, C.
AU - Venat-Bouvet, L.
AU - Provansal, M.
AU - Fabbro, M.
AU - Kaminsky, M. C.
AU - Lortholary, A.
AU - Lecuru, F.
AU - Coquard, I. Ray
AU - de La Motte Rouge, T.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: Malignant ovarian germ cell tumors are rare tumors, affecting young women with a generally favorable prognosis. The French reference network for Rare Malignant Gynecological Tumors (TMRG) aims to improve their management. The purpose of this study is to report clinicopathological features and long-term outcomes, to explore prognostic parameters and to help in considering adjuvant strategy for stage I patients. Patients and methods: Data from patients with MOGCT registered among 13 of the largest centers of the TMRG network were analyzed. We report clinicopathological features, estimated 5-year event-free survival (5y-EFS) and 5-year overall survival (5y-OS) of MOGCT patients. Results: We collected data from 147 patients including 101 (68.7%) FIGO stage I patients. Histology identifies 40 dysgerminomas, 52 immature teratomas, 32 yolk sac tumors, 2 choriocarcinomas and 21 mixed tumors. Surgery was performed in 140 (95.2%) patients and 106 (72.1%) received first line chemotherapy. Twenty-two stage I patients did not receive chemotherapy. Relapse occurred in 24 patients: 13 were exclusively treated with upfront surgery and 11 received surgery and chemotherapy. 5y-EFS was 82% and 5y-OS was 92.4%. Stage I patients who underwent surgery alone had an estimated 5y-EFS of 54.6% and patients receiving adjuvant chemotherapy 94.4% (P <.001). However, no impact on estimated 5y-OS was observed: 96.3% versus 97.8% respectively (P =.62). FIGO stage, complete primary surgery and post-operative alpha fetoprotein level significantly correlated with survival. Conclusion: Adjuvant chemotherapy does not seem to improve survival in stage I patients. Active surveillance can be proposed for selected patients with a complete surgical staging.
AB - Background: Malignant ovarian germ cell tumors are rare tumors, affecting young women with a generally favorable prognosis. The French reference network for Rare Malignant Gynecological Tumors (TMRG) aims to improve their management. The purpose of this study is to report clinicopathological features and long-term outcomes, to explore prognostic parameters and to help in considering adjuvant strategy for stage I patients. Patients and methods: Data from patients with MOGCT registered among 13 of the largest centers of the TMRG network were analyzed. We report clinicopathological features, estimated 5-year event-free survival (5y-EFS) and 5-year overall survival (5y-OS) of MOGCT patients. Results: We collected data from 147 patients including 101 (68.7%) FIGO stage I patients. Histology identifies 40 dysgerminomas, 52 immature teratomas, 32 yolk sac tumors, 2 choriocarcinomas and 21 mixed tumors. Surgery was performed in 140 (95.2%) patients and 106 (72.1%) received first line chemotherapy. Twenty-two stage I patients did not receive chemotherapy. Relapse occurred in 24 patients: 13 were exclusively treated with upfront surgery and 11 received surgery and chemotherapy. 5y-EFS was 82% and 5y-OS was 92.4%. Stage I patients who underwent surgery alone had an estimated 5y-EFS of 54.6% and patients receiving adjuvant chemotherapy 94.4% (P <.001). However, no impact on estimated 5y-OS was observed: 96.3% versus 97.8% respectively (P =.62). FIGO stage, complete primary surgery and post-operative alpha fetoprotein level significantly correlated with survival. Conclusion: Adjuvant chemotherapy does not seem to improve survival in stage I patients. Active surveillance can be proposed for selected patients with a complete surgical staging.
KW - Prognostic factors
KW - Rare malignant ovarian tumors
KW - Stage I
KW - TMRG
UR - http://www.scopus.com/inward/record.url?scp=85087375906&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2020.06.491
DO - 10.1016/j.ygyno.2020.06.491
M3 - Article
C2 - 32624235
AN - SCOPUS:85087375906
SN - 0090-8258
VL - 158
SP - 666
EP - 672
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 3
ER -