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Non-dysgerminomatous Ovarian Tumors: Clinical Characteristics, Treatment and Outcome

Issue: Vol.6, No.1 - January 2007

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Article Type: Manuscript

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  1. Dr Fatemeh Ghaemmaghami
    MD
    Gynaecology Oncology Department, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex
  2. Malihe Hasanzadeh
  3. Azadeh Fallahi

Objective: Assessment response patients with non-dysgerminomatous ovarian germ cell tumors (NDOGCT) to chemotherapy platinum-based and to determine possible prognostic factors for relapse.

Methods: We retrospectively reviewed 21 patients who had surgical resection of non-dysgerminomatous ovarian germ cell tumors (NDOGCT) and received adjuvant chemotherapy in Vali-e-Asr Hospital, Tehran, Iran during 1997-2004. The median age at presentation was 18 years with median follow up of 20 months.

Results: Histologic records showed that patients had the following types of tumors: immature teratoma (n=7), mixed germ cell tumor (n=7), yolk sac tumors (n=4), and embryonal carcinoma tumors (n=3). Distribution by stage at the time of surgery was as follows; stage I (n=10), stage III (n=6), and stage IV (n=5).

Initial surgery included unilateral salpingo-ophorectomy in 16 patients and cystectomy in 5 other patients. After the initial surgery, 13 patients immediately received chemotherapy and the other 8 patients received chemotherapy at a median of 5.5 months (range, 1-40 months). Post operative chemotherapy included the following: bleomycin, etoposide, and cisplatin (n=17); vincristine, actinomycin-D, and cyclophosphamide (n=2); methotrexate, etoposide, and cisplatin (n=l); and cisplatin (n=l). 31% of the patients suffered a relapse after cisplatin combination chemotherapy. The median disease free survival was 40 months and the median overall survival was 50 months. The 5 year survival rate was 39%.

Conclusion: This study showed that residual disease and the interval from initial diagnosis to the start of chemotherapy were possible prognostic factors for relapse. Also our study indicates that there may be a role for aggressive cytoreductive surgery in advance NDOGCT, and need to look for feasible second-line combination chemotherapy.

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