Outcomes of ovarian germ cell tumors: ten years of experience at the Brazilian National Cancer Institute

Int J Gynecol Cancer. 2015 Jun;25(5):786-91. doi: 10.1097/IGC.0000000000000432.

Abstract

Objective: Ovarian germ cell malignancies are a rare group of chemosensitive malignances that predominantly occur in young women. Bleomycin, etoposide, cisplatin (BEP) regimen was consolidated, by previous studies, as the standard treatment. This Brazilian single institutional study was performed to evaluate our experience in treating patients with ovarian germ cell tumors (OGCTs).

Methods/materials: A retrospective analysis of all patients as having OGCTs, from April 2003 to July 2013, was carried out at the Brazilian National Cancer Institute.

Results: Data on 30 patients were obtained, and 19 patients were treated with BEP. Median overall survival and progression-free survival were not reached. Just 4 (13.3%) patients had progressed and 5 (16.7%) had died up to the date of analysis. The proportion of patients who had dysgerminoma was 53.3%. From the 18 patients considered to have had an incomplete resection, 84.6% achieved objective response (partial or complete response) with chemotherapy. Patients with stage IV and incomplete resection had markedly ominous prognosis. Alopecia was the most frequent adverse event; grade 2 was presented in 17 (89.4%) patients. Nausea and vomiting were related by more than one-half of the patients. Grade 3 and 4 neutropenia was presented in 5 (26.3%) patients. One patient died of pneumonitis related to bleomycin.

Conclusions: Our study confirms the effectiveness of BEP regimen and the great prognosis for patients with OGCTs. Advanced-stage and persistent disease configured as an important risk factor for survival. The chemotherapy regimen was associated with significant but manageable toxicity.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bleomycin / administration & dosage
  • Brazil
  • Cisplatin / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Neoplasms, Germ Cell and Embryonal / drug therapy*
  • Neoplasms, Germ Cell and Embryonal / mortality
  • Neoplasms, Germ Cell and Embryonal / pathology
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology
  • Prognosis
  • Remission Induction
  • Retrospective Studies
  • Survival Rate
  • United States
  • Young Adult

Substances

  • Bleomycin
  • Etoposide
  • Cisplatin

Supplementary concepts

  • Ovarian Germ Cell Cancer