Treatment Strategies and Survival in Women with Malignant Ovarian Germ Cell Tumors

2020 Year in Review - Ovarian Cancer

Despite substantial rates of intraoperative tumor spillages, patients with ovarian germ cell tumors (OGCTs) had an excellent prognosis, and adjuvant chemotherapy showed evidence of preventing disease recurrence.

In Western countries, approximately 5% of all ovarian malignancies are malignant OGCTs. A clinicopathological database for a better documentation and understanding of this rare disease has been established, called Current Ovarian Germ Cell and Sex Cord Stromal Tumour Treatment (CORSETT) strategies.

At the European Society of Gynaecological Oncology 2020 Virtual Conference, Annette Hasenburg and colleagues presented the first analysis of patients with confirmed OGCTs from the CORSETT database. A mixture of retrospective and prospective data from patients with OGCTs was provided by 20 German centers in the database. All these patients had histology specimens and had been treated between 2000 and 2014.

The majority of the patients diagnosed had stage I disease; 20 patients were diagnosed with dysgerminoma, 11 with malignant teratoma, and 14 with mixed OGCTs. The median age of patients with dysgerminoma, teratoma, and mixed OGCTs was 30.2, 36.4, and 35.6 years, respectively.

Laparoscopic treatment was performed in 63.8% of patients with dysgerminoma, in 38.1% with teratoma, and in 31.6% with mixed OGCTs. Intraoperative tumor rupturing occurred in 21% of dysgerminoma cases, in 22% of teratoma cases, and in 50% of mixed OGCT cases. Fertility-sparing surgery was used in 85.6% of patients with dysgerminoma, in 85% with teratoma, and in 78.9% with mixed OGCTs.

Fifty-seven percent of patients with dysgerminoma, 55% with teratoma, and 70% with mixed OGCTs were administered adjuvant chemotherapy, which decreased the likelihood of disease recurrence significantly in patients with mixed OGCTs to the highest degree (hazard ratio, 0.21; 95% confidence interval, 0.04-0.97). In total, disease recurrence was experienced by 4.6%, 14.3%, and 45% of patients with dysgerminoma, teratoma, and mixed OGCTs, respectively. In the total cohort of patients with OGCTs, the median progression-free and overall survival were not reached.

The investigators concluded that despite substantial rates of intraoperative tumor spillages, patients with OGCTs had an excellent prognosis, and adjuvant chemotherapy showed evidence of preventing disease recurrence.

Source: Hasenburg A, et al. Int J Gynecol Cancer. 2020;30(4_suppl). Abstract 293.

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