Malignant ovarian germ cell tumors in pediatric patients: The AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) study

Abstract

Objective: Malignant ovarian germ cell tumors (MOGCT) carry an excellent prognosis, and the treatment aims to achieve results with the least possible treatment-related morbidity. The aim of this study was to assess the outcomes of pediatric patients with MOGCT. 5-year overall survival [OS] 100%), seven relapsed (three patients with Dysg and four patients with Non-Dysg) and were rescued with chemotherapy (plus surgery in three patients). Among the evaluable patients with stages II-IV, 48 (98%) achieved complete remission after chemotherapy ± surgery, one (IT + AFP, stage IV) had progressive disease. In the whole series (median follow-up 80 months), the 5-year OS and EFS were 98.5% (95% CI: 95.6-100%) and 84.5% (95% CI: 76.5-93.5%). Conclusions:We confirm the excellent outcome for MOGCT. Robust data are lacking on surgical staging, surveillance for Non-Dysg with stage I, the management of IT + AFP, and the most appropriate BEP regimen. As pediatric oncologists, we support the role of surveillance after proper surgical staging providing cases are managed by experts at specialized pediatric centers.

Tumor-infiltrating T cells and PD-L1 expression in childhood malignant extracranial germ-cell tumors

“…28 Although the majority of patients are cured by surgery and chemotherapy, a subgroup of them relapse. [29][30][31][32][33] Current therapeutic options are effective in less than 50% of patients with high-risk disease, indicating that more effective and less toxic therapies are urgently needed.…”

Malignant testicular germ cell tumors in children and adolescents: The AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) protocol

“…Males with pure T, or nonÀgerm-cell component were excluded. Patients were followed up with abdominal ultrasound and chest X-rays, clinical examinations, aFP, and b-hCG assay as described elsewhere [4]. Staging was done according to the Children's Oncology Group (COG) [5], modified system (Table 1).…”

“…Response criteria were as reported elsewhere [4]. If marker levels were high at diagnosis, cases were only classified as progressing if tumor growth coincided with further increasing marker levels.…”

Hot Flushes in a 15-Year-Old Girl Post Treatment of Bilateral Ovarian Dysgerminoma: A Case Report

“…The current standard management protocol for MOGCT is complete cytoreductive surgery followed by adjuvant chemotherapy, as in this case. However, just surgical treatment without adjuvant chemotherapy has recently been proposed for patients with FIGO stage 1 ovarian tumors [7,8]. In a study of 25 children and adolescents with a mean age of 12 years, Billmire, et al [9] evaluated the surgery-only, watch-and-wait strategy and found that the overall oncologic outcomes were not impaired and 50% of the patients avoided having to take adjuvant chemotherapy.…”