Outcome and prognostic factors in ovarian germ cell malignancies

Chyong Huey Lai, Ting Chang Chang, Swei Hsueh, Tzu I. Wu, Angel Chao, Hung Hsueh Chou, Po Nan Wang

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Objectives. This study was undertaken to investigate the outcome and prognostic factors in patients with ovarian germ cell malignancies (OGCMs). Methods. A total of 93 patients with OGCMs were retrospectively reviewed, among whom 84 patients had primary treatment at Chang Gung Memorial Hospital (CGMH) between 1984 and 2003. The other nine patients were primarily treated outside and referred for follow-up (n = 1), adjuvant chemotherapy (n = 4), or salvage therapy after recurrence (n = 4). The clinicopathological and treatment-related characteristics were analyzed for association with the occurrence of tumor persistence/recurrence or death. Results. Of the study patients, 32 had dysgerminoma (DSG), 29 immature teratoma (IMT), 23 endodermal sinus tumor, 7 mixed germ cell tumors, and 1 each had choriocarcinoma and embryonal carcinoma. The median follow-up of survivors was 66 months (range, 12-236 months). The median time to recurrence or progression was 8 months. There were 11 treatment failures with 6 died of cancer. The 5-year survival rate was 97.4% for those primarily treated at CGMH. Histology (DSG/IMT versus non-DSG/IMT) (P <0.0001) and International Federation of Gynecology and Obstetrics stage (P = 0.001) were significantly associated with treatment failure, while histology (P = 0.0004), salvage high-dose chemotherapy (HD-CT) after primary chemotherapy failed (P = 0.0405), and residual tumor after salvage surgery (P = 0.0014) were significant prognostic factors for overall survival. Conclusions. Prognosis of OGCMs is excellent if managed with standard treatment initially. Aggressive HD-CT with salvage surgery needs to be applied for recurrent/persistent disease after primary chemotherapy.

Original languageEnglish
Pages (from-to)784-791
Number of pages8
JournalGynecologic Oncology
Volume96
Issue number3
DOIs
Publication statusPublished - Mar 2005
Externally publishedYes

Fingerprint

Germ Cells
Teratoma
Dysgerminoma
Drug Therapy
Neoplasms
Treatment Failure
Recurrence
Histology
Embryonal Carcinoma
Endodermal Sinus Tumor
Salvage Therapy
Choriocarcinoma
Germ Cell and Embryonal Neoplasms
Residual Neoplasm
Adjuvant Chemotherapy
Gynecology
Obstetrics
Survivors
Therapeutics
Survival Rate

Keywords

  • Germ cell malignancy
  • High-dose chemotherapy
  • Ovarian neoplasm
  • Prognosis
  • Recurrence

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Lai, C. H., Chang, T. C., Hsueh, S., Wu, T. I., Chao, A., Chou, H. H., & Wang, P. N. (2005). Outcome and prognostic factors in ovarian germ cell malignancies. Gynecologic Oncology, 96(3), 784-791. https://doi.org/10.1016/j.ygyno.2004.11.027

Outcome and prognostic factors in ovarian germ cell malignancies. / Lai, Chyong Huey; Chang, Ting Chang; Hsueh, Swei; Wu, Tzu I.; Chao, Angel; Chou, Hung Hsueh; Wang, Po Nan.

In: Gynecologic Oncology, Vol. 96, No. 3, 03.2005, p. 784-791.

Research output: Contribution to journalArticle

Lai, CH, Chang, TC, Hsueh, S, Wu, TI, Chao, A, Chou, HH & Wang, PN 2005, 'Outcome and prognostic factors in ovarian germ cell malignancies', Gynecologic Oncology, vol. 96, no. 3, pp. 784-791. https://doi.org/10.1016/j.ygyno.2004.11.027
Lai, Chyong Huey ; Chang, Ting Chang ; Hsueh, Swei ; Wu, Tzu I. ; Chao, Angel ; Chou, Hung Hsueh ; Wang, Po Nan. / Outcome and prognostic factors in ovarian germ cell malignancies. In: Gynecologic Oncology. 2005 ; Vol. 96, No. 3. pp. 784-791.
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abstract = "Objectives. This study was undertaken to investigate the outcome and prognostic factors in patients with ovarian germ cell malignancies (OGCMs). Methods. A total of 93 patients with OGCMs were retrospectively reviewed, among whom 84 patients had primary treatment at Chang Gung Memorial Hospital (CGMH) between 1984 and 2003. The other nine patients were primarily treated outside and referred for follow-up (n = 1), adjuvant chemotherapy (n = 4), or salvage therapy after recurrence (n = 4). The clinicopathological and treatment-related characteristics were analyzed for association with the occurrence of tumor persistence/recurrence or death. Results. Of the study patients, 32 had dysgerminoma (DSG), 29 immature teratoma (IMT), 23 endodermal sinus tumor, 7 mixed germ cell tumors, and 1 each had choriocarcinoma and embryonal carcinoma. The median follow-up of survivors was 66 months (range, 12-236 months). The median time to recurrence or progression was 8 months. There were 11 treatment failures with 6 died of cancer. The 5-year survival rate was 97.4{\%} for those primarily treated at CGMH. Histology (DSG/IMT versus non-DSG/IMT) (P <0.0001) and International Federation of Gynecology and Obstetrics stage (P = 0.001) were significantly associated with treatment failure, while histology (P = 0.0004), salvage high-dose chemotherapy (HD-CT) after primary chemotherapy failed (P = 0.0405), and residual tumor after salvage surgery (P = 0.0014) were significant prognostic factors for overall survival. Conclusions. Prognosis of OGCMs is excellent if managed with standard treatment initially. Aggressive HD-CT with salvage surgery needs to be applied for recurrent/persistent disease after primary chemotherapy.",
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AU - Lai, Chyong Huey

AU - Chang, Ting Chang

AU - Hsueh, Swei

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AU - Chao, Angel

AU - Chou, Hung Hsueh

AU - Wang, Po Nan

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N2 - Objectives. This study was undertaken to investigate the outcome and prognostic factors in patients with ovarian germ cell malignancies (OGCMs). Methods. A total of 93 patients with OGCMs were retrospectively reviewed, among whom 84 patients had primary treatment at Chang Gung Memorial Hospital (CGMH) between 1984 and 2003. The other nine patients were primarily treated outside and referred for follow-up (n = 1), adjuvant chemotherapy (n = 4), or salvage therapy after recurrence (n = 4). The clinicopathological and treatment-related characteristics were analyzed for association with the occurrence of tumor persistence/recurrence or death. Results. Of the study patients, 32 had dysgerminoma (DSG), 29 immature teratoma (IMT), 23 endodermal sinus tumor, 7 mixed germ cell tumors, and 1 each had choriocarcinoma and embryonal carcinoma. The median follow-up of survivors was 66 months (range, 12-236 months). The median time to recurrence or progression was 8 months. There were 11 treatment failures with 6 died of cancer. The 5-year survival rate was 97.4% for those primarily treated at CGMH. Histology (DSG/IMT versus non-DSG/IMT) (P <0.0001) and International Federation of Gynecology and Obstetrics stage (P = 0.001) were significantly associated with treatment failure, while histology (P = 0.0004), salvage high-dose chemotherapy (HD-CT) after primary chemotherapy failed (P = 0.0405), and residual tumor after salvage surgery (P = 0.0014) were significant prognostic factors for overall survival. Conclusions. Prognosis of OGCMs is excellent if managed with standard treatment initially. Aggressive HD-CT with salvage surgery needs to be applied for recurrent/persistent disease after primary chemotherapy.

AB - Objectives. This study was undertaken to investigate the outcome and prognostic factors in patients with ovarian germ cell malignancies (OGCMs). Methods. A total of 93 patients with OGCMs were retrospectively reviewed, among whom 84 patients had primary treatment at Chang Gung Memorial Hospital (CGMH) between 1984 and 2003. The other nine patients were primarily treated outside and referred for follow-up (n = 1), adjuvant chemotherapy (n = 4), or salvage therapy after recurrence (n = 4). The clinicopathological and treatment-related characteristics were analyzed for association with the occurrence of tumor persistence/recurrence or death. Results. Of the study patients, 32 had dysgerminoma (DSG), 29 immature teratoma (IMT), 23 endodermal sinus tumor, 7 mixed germ cell tumors, and 1 each had choriocarcinoma and embryonal carcinoma. The median follow-up of survivors was 66 months (range, 12-236 months). The median time to recurrence or progression was 8 months. There were 11 treatment failures with 6 died of cancer. The 5-year survival rate was 97.4% for those primarily treated at CGMH. Histology (DSG/IMT versus non-DSG/IMT) (P <0.0001) and International Federation of Gynecology and Obstetrics stage (P = 0.001) were significantly associated with treatment failure, while histology (P = 0.0004), salvage high-dose chemotherapy (HD-CT) after primary chemotherapy failed (P = 0.0405), and residual tumor after salvage surgery (P = 0.0014) were significant prognostic factors for overall survival. Conclusions. Prognosis of OGCMs is excellent if managed with standard treatment initially. Aggressive HD-CT with salvage surgery needs to be applied for recurrent/persistent disease after primary chemotherapy.

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KW - High-dose chemotherapy

KW - Ovarian neoplasm

KW - Prognosis

KW - Recurrence

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