Palenzuela G et al. (2008) Comprehensive staging allows for excellent outcome in patients with localized malignant germ cell tumor of the ovary. Ann Surg 248: 836–841

Malignant germ-cell tumors of the ovary are rare and can be treated with cisplatin-based combination chemotherapy or ovariectomy. To achieve high cure rates for this disease a multidisciplinary approach is required. Palenzula et al. carried out a retrospective study to analyze outcomes in a cohort of patients who underwent surgical or medical management for malignant germ-cell tumors of the ovary.

The study included 60 patients treated for primary malignant germ-cell tumors of the ovary at two centers in France, between 1985 and 2003. The patient's case records were obtained and analyzed for information on diagnosis, surgery and medical decisions. A total of 38 tumors were stage I, and 22 were advanced. The mean follow-up period was 5.9 years. During follow-up, 16.7% of patients experienced relapse. In general, relapse occurred more frequently in patients with localized disease, possibly because those with advanced disease had received adjuvant chemotherapy. Overall survival at 5 years of follow-up was 96.7% and event-free survival was 79.2%. Patients who underwent postsurgical observation and those with yolk-sac tumor had an increased risk of relapse. The type of surgery or chemotherapy used had no prognostic value.

The authors conclude that outcomes of patients with malignant germ-cell ovarian tumors can be greatly influenced by accurate staging and adherence to surgical and medical guidelines.