Malignant ovarian germ cell tumors: identification of novel prognostic markers and long-term outcome after multimodality treatment

J Clin Oncol. 2006 Oct 20;24(30):4862-6. doi: 10.1200/JCO.2006.06.2489.

Abstract

Purpose: Malignant ovarian germ cell tumors are rare and knowledge about prognostic parameters currently is limited. This study was undertaken to evaluate long-term outcome of patients with malignant ovarian germ cell tumors (MOGCTs) after chemotherapy and to assess prognostic parameters.

Patients and methods: A total of 113 patients with stage IC to IV MOGCTs were included into this retrospective study. Patients were treated at two large regional cancer centers between 1977 and 2003.

Results: Ten-year recurrence-free and overall survival rates were 82% and 81%, respectively. A total of 20 patients experienced relapse, all within the first 8 years. Outcome after relapse was poor, with only 10% of patients achieving long-term survival. Univariate and multivariate analyses demonstrated that initial stage of disease (relative risk [RR], 5.96; 95% CI, 3.47 to 10.22; P = .03) and elevation of serum markers beta-human chorionic gonadotropin and alpha-fetoprotein (RR, 3.90; 95% CI, 1.40 to 10.9; P = .009) were significant predictors of overall survival, whereas age at diagnosis was of no prognostic value.

Conclusion: This is the first study to identify stage and tumor markers as prognostic parameters for patients with MOGCTs. This might help to select patients for risk-adapted treatment. There is need for improvement of therapeutic strategies after relapse.

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers, Tumor / blood*
  • Child
  • Child, Preschool
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Combined Modality Therapy
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms, Germ Cell and Embryonal / blood*
  • Neoplasms, Germ Cell and Embryonal / therapy*
  • Ovarian Neoplasms / blood*
  • Ovarian Neoplasms / therapy*
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome
  • alpha-Fetoproteins / analysis*

Substances

  • Biomarkers, Tumor
  • Chorionic Gonadotropin, beta Subunit, Human
  • alpha-Fetoproteins