Non-seminomatous ovarian germ cell tumours in children

• Published in: European journal of cancer (1990) Vol. 36; no. 3; pp. 376 - 383
• Main Authors: Baranzelli, M.C., Bouffet, E., Quintana, E., Portas, M., Thyss, A., Patte, C.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.02.2000; Elsevier
• Subjects: Adolescent; alpha-Fetoproteins - metabolism; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Chemotherapy; Child; Child, Preschool; Children; Chorionic Gonadotropin - metabolism; Female; Female genital diseases; Follow-Up Studies; Germ cell tumours; Germinoma - drug therapy; Germinoma - metabolism; Germinoma - mortality; Gynecology. Andrology. Obstetrics; Humans; Immature teratoma; Infant; Medical sciences; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - metabolism; Ovarian Neoplasms - mortality; Ovary; Surgery; Survival Analysis; Teratoma - drug therapy; Tumors; α-Fetoprotein; Immature teratoma; Ovary; Chemotherapy; Germ cell tumours; Surgery; Children; α-Fetoprotein; Human; Treatment efficiency; Adjuvant treatment; Non seminomatous tumor; Malignant tumor; Female genital diseases; Germ cell tumor; Ovarian diseases; Pathology; Female; Therapeutic protocol; Child; Comparative study
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/S0959-8049(99)00317-2

In this study, we report the results of two consecutive protocols, TGM 85 and TGM 90, of the Société Française d'Oncologie Pédiatrique (SFOP) for patients with non-seminomatous germ cell tumours of the ovary and analyse the rationale for surgical indications, neoadjuvant or adjuvant chemotherapy. TGM 85 and 90 both utilised six drugs, bleomycin, cyclophosphamide, vinblastine, dactinomycin, etoposide and either cisplatin (TGM 85) or carboplatin (TGM 90). Chemotherapy was given in case of unresectable or incompletely resected tumour. Patients who had a complete resection of a localised tumour underwent expectant management and were only treated if progression occurred. 63 patients aged less than 18 years old were enrolled between January 1985 and December 1994. 49 patients had α-fetoprotein (αFP)±β-human chorionic gonadotropic hormone (βHCG) secreting tumours and 14 had immature teratomas. Median follow-up for surviving patients is 60 months (range: 19–154). The 5-year overall survival is 85%±5%. 13 out of 14 patients (93%) with immature teratoma are alive, including 3 of 4 patients (75%) who received chemotherapy for advanced disease. 41 patients (84%) with secreting tumours are alive, including 2 patients who required salvage treatment. Most failures occurred amongst patients with high initial αFP secretion (>15 000 ng/ml). 39 of 41 survivors (95%) in the non-teratoma group had conservative surgery, allowing the possibility of future pregnancy. High cure rate can be achieved with a conservative approach in non-seminomatous germ cell tumour of the ovary. Whenever possible, fertility should be preserved during the primary operation in children suffering from these tumours.