Need for risk-adapted therapy for malignant ovarian germ cell tumors: A large multicenter analysis of germ cell tumors' patients from French TMRG network

• Published in: Gynecologic oncology 2020-09, Vol.158 (3), p.666-672
• Main Authors: Derquin, F., Floquet, A., Hardy-Bessard, A.C., Edeline, J., Lotz, J.P., Alexandre, J., Pautier, P., Angeles, M.A., Delanoy, N., Lefeuvre-Plesse, C., Cancel, M., Treilleux, I., Augereau, P., Lavoue, V., Kalbacher, E., Berton Rigaud, D., Selle, F., Nadeau, C., Gantzer, J., Joly, F., Guillemet, C., Pomel, C., Favier, L., Abdeddaim, C., Venat-Bouvet, L., Provansal, M., Fabbro, M., Kaminsky, M.C., Lortholary, A., Lecuru, F., Coquard, I. Ray, de La Motte Rouge, T.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Choriocarcinoma - drug therapy; Choriocarcinoma - pathology; Choriocarcinoma - surgery; Choriocarcinoma - therapy; Dysgerminoma - drug therapy; Dysgerminoma - pathology; Dysgerminoma - surgery; Dysgerminoma - therapy; Endodermal Sinus Tumor - drug therapy; Endodermal Sinus Tumor - pathology; Endodermal Sinus Tumor - surgery; Endodermal Sinus Tumor - therapy; Female; Humans; Life Sciences; Middle Aged; Neoplasm Staging; Neoplasms, Germ Cell and Embryonal - drug therapy; Neoplasms, Germ Cell and Embryonal - pathology; Neoplasms, Germ Cell and Embryonal - surgery; Neoplasms, Germ Cell and Embryonal - therapy; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Ovarian Neoplasms - therapy; Prognosis; Prognostic factors; Rare malignant ovarian tumors; Retrospective Studies; Stage I; Teratoma - drug therapy; Teratoma - pathology; Teratoma - surgery; Teratoma - therapy; TMRG; Watchful Waiting; Young Adult
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2020.06.491

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. 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. 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