Clinical Analysis Of Malignant Ovarian Germ Cell Tumors

Background and Objectives:Malignant ovarian germ cell tumors(MOGCT)are extremely malignancies which occur in children and adolescents.The previous therapy of MOGCT was only dependent on surgery.Survival rate was very lower.With further effective application of chemotherapy,5-year survival rate was improved from about 10%～20%to 90%or more.It was also highest survival of solid tumors. Therapy of MOGCT has radical changed,fertility-preserving surgery followed by cisplatin-based combination chemotherapy has become a standard choice in patients with MOGCT.A case series analysis was performed on patients with ovarian malignant germ cell tumors seen or consulted on,explores rational therapy for clinical practice.Method:1.Clinical characteristics and Follow-up information of 111 cases was obtained and analysised retrospectively between November 2005 and October 2006 at Tumor Hospital of Guangxi Medical University for evaluation of outcome.2.Survival analysis was calculated by Life-Table method.Single-factor prognostic analysis was identified by Long-rank.Multivariate analysis as performed by COX proportional hazards regression model. Results:1.Malignant ovarian germ cell tumors account for 16.0%of all ovarian neoplasms.The most common pathologic type of MOGCT was endodermal sinus tumor,immature teratoma and dysgerminoma.2.The most common symptom was abdominal masses,pain and welling.3.There was no significant impact on prognosis between fertility-preserving surgery and radical surgery.Appendicectomy or removal of omentum was not significantly related to prognosis.Retroperitoneal lymphadenectomy was significantly related to prognosis.4.More than 4 cycles of chemotherapy an PEB regimen was significantly related to prognosis.5.1-,3-,5-,10-year survival rate in 111 cases of MOGCT was 86%,67%,56%, 27%respectively.Mean survival time was 71.6 months.6.Single-factor analysis showed that stage,retroperitoneal lymphadenectomy, courses of chemotherapy and chemotherapy regimen were factors related to prognosis.7.Multivariate analysis showed that the stage of tumor,courses of chemotherapy were independent prognostic factors.Conclusion:1.Early diagnosis,promptly surgery followed effective chemotherapy was the most methods for improving survival.2.Conservative surgery and postoperative chemotherapy of PEB regimen can improve prognosis and long-term survival.