Outcome and staging evaluation in malignant germ cell tumors of the ovary in children and adolescents: an intergroup study
Section snippets
Materials and methods
Two intergroup studies for extracranial malignant germ cell tumors in children and adolescents were undertaken by the Pediatric Oncology Group (POG) and Children’s Cancer Study Group (CCG) from 1990 to 1996. Children with stage I and II ovarian tumors were entered onto POG 9048/CCG 8891 and were treated in a nonrandomized fashion with tumor resection followed by 4 cycles of chemotherapy. The regimen included cisplatin, 100 mg/m2/d×5, etoposide 100 mg/m2/d×5 and bleomycin 15 mg/m2/d×1 (PEB) for
Results
There were 131 girls with malignant germ cell tumors of the ovary entered onto the combined intergroup studies including 41 stage I, 16 stage II, 58 stage III, and 16 stage IV tumors. Age ranged from 1.4 to 20 years with mean age of 11.9 yrs.
Information on clinical presentation was available from the operative notes in 82 patients. Of these 82 girls, 9 presented with an acute abdomen with a preoperative diagnosis of appendicitis in 7 and peritonitis in 2. Three of these girls had torsion of the
Discussion
Survival rate of girls with malignant germ cell tumors of the ovary was excellent in this study with an incidence of only 3% (4 of 131) primary tumor-related mortality. Previous recommendations for extensive surgical resection of reproductive organs1 have been successfully abandoned without compromise in outcome. The high survival rate with conservative surgery can be credited to the development of effective chemotherapeutic agents. There still is significant variability in surgical procedure,
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