Childhood malignant ovarian germ cell tumors: a single institution experience

Purpose of investigation: This study aimed to analyze the clinical characteristics and outcome of children with malignant ovarian germ cell tumors (MOGCTs), and to investigate the therapeutic strategy. Materials and Methods: All patients with MOGCTs in a single institution during the period January 2001 to December 2012 were analyzed according to the characteristics of patients, treatment, and outcome. Results: Eight-nine patients with MOGCTs had a median age 9.5 (range, 0-15) years. Abdominal pain and abdominal distension were the most frequent clinical presentations. Elevated APP was observed in 78 cases (87.6%). Eighty-seven patients received surgery plus chemotherapy. The surgical procedures consisted of salpingo-oophorectomy plus omentectomy (n=39), salpingo-oophorectomy (n=39), and oophorectomy (n=11). Five patients died: three from disease, one from leukopenic sepsis, and one from disseminated varicella. The overall five-year survival rate was 95.5% for all patients, 100% for Stage I, 96.2% for Stage II, 95% for Stage III, 91.7% for Stage IV, and 71.4% for relapse patients, respectively. Forty-one out of 49 patients in puberty or reproductive age had regular menstrual cycles. Six patients had menostaxis, and two patients required psychological input during the follow up period. Two patients delivered healthy infants without congenital defects. Conclusion: The prognosis of malignant ovarian germ cell tumor is favorable. Surgery combined with platinum-based chemotherapy can improve curative efficacy and survival. Further investigation of novel and high-dose chemotherapic regimens is needed for the patients with relapsed tumors. Sex hormone replacement therapy is not necessary for most patients receiving fertility-preserving surgery.