Outcome and Risk Factors for Recurrence in Malignant Ovarian Germ Cell Tumors

Mangili, Giorgia; Sigismondi, Cristina; Gadducci, Angiolo; Cormio, Gennaro; Scollo, Paolo; Tateo, Saverio; Ferrandina, Gabriella; Greggi, Stefano; Candiani, Massimo; Lorusso, Domenica

doi:10.1097/igc.0b013e3182236582

Cited by 99 publications

(66 citation statements)

References 25 publications

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“…Known immunohistochemistry markers tend to lack sensitivity. Correct identification of YST is however essential, since this component is an independent poor prognostic indicator [8,9]. In a series of 49 YSTs from 45 patients, we show that HNF1, a factor necessary for early visceral endoderm differentiation, represents a highly sensitive immunohistochemical diagnostic marker for YST.…”

Section: Discussionmentioning

confidence: 99%

Role of HNF1β in the differential diagnosis of yolk sac tumor from other germ cell tumors

Rougemont

Tille

2018

Human Pathology

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Identification of the yolk sac tumor (YST) component in germ cell tumors (GCT) may prove challenging, and highly sensitive and specific immunohistochemical markers are still lacking.Preliminary data from the literature suggest that HNF1 may represent a sensitive marker of YST. The specificity of HNF1 has not been addressed in GCT. A cohort of 49 YST specimens from 45 patients was designed, occurring either as pure tumors, or as a component of a mixed GCT. Immunohistochemistry was conducted on whole tumor sections using HNF1. SALL4, OCT4, CD30, CDX2, Cytokeratin 19, Glypican 3, and GATA3 were used for classification of the GCT components. Patients were mostly male (39/45), aged 14 months to 49 years, with primary testicular tumors (37/39), or primary mediastinal pure YSTs (2/39).All 6 primary tumors occurring in females (6/45) were pure ovarian YSTs; age range was 4 to 72 years. HNF1 nuclear reactivity was seen in the YST component in all 49 tumors, with a moderate to strong nuclear pattern of staining. Embryonal carcinoma (EC, 0/32) and seminoma (0/6) were negative. Choriocarcinoma (6/6) showed faint focal cytoplasmic reactivity to HNF1 but no nuclear staining. In teratomas, only enteric-type glands showed nuclear reactivity to HNF1 (11/16). Therefore, HNF1 sensitivity in YST component identification was 100% and specificity was 80%. Thus, in our experience, HNF1 is a sensitive and reliable marker of the YST component in GCT, and allows distinction of YST from intricately admixed EC, especially in the diffuse embryoma pattern. Abstract Word Count: 243

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Section: Discussionmentioning

confidence: 99%

Role of HNF1β in the differential diagnosis of yolk sac tumor from other germ cell tumors

Rougemont

Tille

2018

Human Pathology

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“…155,156 Germ cell tumors are the predominant ovarian tumor in this age group. 157 The recommended workup may include pulmonary function studies if bleomycin is being considered (see OV-B, 4 of 7; page 1146).…”

Section: Malignant Germ Cell Tumorsmentioning

confidence: 99%

Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Morgan

Armstrong

Alvarez

et al. 2016

J Natl Compr Canc Netw

300

233

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“…17 Several authors demonstrated that residual disease after initial surgery is a prognostic factor for malignant germ cell tumour patients. 18 In present study 3 patients (14%) who presented with relapse had residual disease after surgery and were stage III at initial presentation.…”

Section: Discussionmentioning

confidence: 97%

Treatment outcomes in malignant ovarian germ cell tumors

Kumar

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Malignant ovarian germ cell tumours are rare group of ovarian neoplasms derived from primordial germ cells of the ovary. Objective of present study was to evaluate the outcome of treatment in malignant germ cell tumours.Methods: 21 Patients of malignant ovarian germ cell tumours registered at Department of Medical Oncology, Institute of Obstetrics and Gynaecology, Chennai for the period from January 2012 to December 2015 were retrospectively analyzed for treatment outcomes.Results: The median age at presentation was 21 years with age range between 14 and 40 years. 9patients (43%) presented with mixed germ cell tumour, 6 patients (29%) with dysgerminoma, 3 patients (14%) with yolk sac tumour and 3 patients (14%)with mature cystic teratoma. 13 patients (62%) presented with Stage I disease, 5 patients (24%) with Stage III and 3 patients (14%) with Stage II. Fertility sparing surgery was done in 15 patients (71%), and 4 patients (19%) who completed family had TAH with BSO done. Adjuvant Chemotherapy was given for 16 patients (76%) and as Neoadjuvant in 2patients (10%) who had biopsy alone performed. 4patients (19%) developed recurrence and was taken for salvage PVI chemotherapy.Conclusions: Malignant ovarian germ cell tumours are relatively uncommon neoplasms characterized by high chemo sensitivity. This study confirms that malignant ovarian germ cell tumours have excellent prognosis and the effectiveness of BEP chemotherapy regimen. Fertility sparing surgery is feasible in most cases. Advanced Stage configured as an important risk factor for survival. The chemotherapy regimen was associated with significant but manageable toxicity.

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Outcome and Risk Factors for Recurrence in Malignant Ovarian Germ Cell Tumors

Cited by 99 publications

References 25 publications

Role of HNF1β in the differential diagnosis of yolk sac tumor from other germ cell tumors

Role of HNF1β in the differential diagnosis of yolk sac tumor from other germ cell tumors

Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Treatment outcomes in malignant ovarian germ cell tumors

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