Treatment of malignant ovarian germ cell tumors and preservation of fertility

Eur J Gynaecol Oncol. 2012;33(5):489-92.


Objective: To explore the prognostic factors, as well as the menstrual and reproductive outcomes, of malignant ovarian germ cell tumors following a fertility-preserving treatment.

Methods: A total of 145 patients with malignant ovarian germ cell tumors who had undergone fertility-preserving management in the past 20 years were analyzed retrospectively. The correlative factors for survival, recurrence, and reproductive status were evaluated. The median follow-up time was 9.5 years. Thirty-five cases suffered from dysgerminoma, 31 cases from endodermal sinus tumor, 63 cases from immature teratoma, two cases from embryonal carcinoma, 13 cases from mixed germ cell tumor, and one case had malignant struma. The overall five-year survival rate was 90.3%, whereas the ten-year survival rate was 89.2%. The five-year survival rates for the different stages were as follows: Stage I, 98.1%; Stage II, 5/5; Stage III, 73.3%; and recurrence, 64.1%. The five-year survival rates were 100% for dysgerminoma, 84.1% for endodermal sinuse tumors, 92.0% for immature teratoma, one of two cases for embryonal carcinoma, 76.9% for mixed germ cell tumors, and one case of malignant struma.

Results: Thirty-five babies were delivered, whereas seven induced abortions were performed during the follow-up. The important prognostic factors included the International Federation of Gynecology and Obstetrics (FIGO) stage and standard chemotherapy. No statistical significance in the five-year survival rates was determined among the different histological types, surgery types, chemotherapy courses, and chemotherapy regimen. Fertility-preserving treatment should be considered for ovarian germ cell tumors without the limitation of the FIGO stage.

Conclusion: Chemotherapy does not influence the menses, pregnancy, or offspring. Recurrent cases could obtain a good prognosis after the proper treatment.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Fertility Preservation*
  • Humans
  • Neoplasm Staging
  • Neoplasms, Germ Cell and Embryonal / mortality
  • Neoplasms, Germ Cell and Embryonal / pathology
  • Neoplasms, Germ Cell and Embryonal / therapy*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy*
  • Pregnancy
  • Survival Rate