Surveillance policy for stage I ovarian germ cell tumors.

Abstract

Our experience emphasizes that patients with true stage Ia ovarian GCT are adequately managed by surgical resection followed by careful clinical, radiologic, and serologic surveillance. These patients do not require adjuvant chemotherapy or radiotherapy, thus avoiding the potential complications of secondary leukemia and infertility.

Cancer of the ovary, fallopian tube, and peritoneum

“…This schedule is based on the experience managing seminomas in males and the reports by Patterson et al [112] and Dark et al [113]. This pragmatic follow-up schedule and has not been tested in randomized trials.…”

“…Patients who have Stage I tumors and who are offered surveillance need to be seen regularly and one option is to utilize the follow-up regimen presented above [113]. Patients who have had chemotherapy have a lower risk of recurrence and the frequency of CT scans can be reduced, which is similar to the approach for testicular germ cell tumors [112].…”

“…Although tumor markers are important, radiological imaging is also pertinent, especially for patients whose tumor markers were not raised at diagnosis. CT or MRI scans should be performed as clinically indicated [113].…”

“…Ninety percent of relapses in these patients occur within the first 2 years. At relapse, with few exceptions, these patients can be successfully treated [113]. Level of Evidence D 12.5.…”

“…Following surgery, patients should receive platinum-based chemotherapy [95,113,114]. The follow-up schedule is as recommended for epithelial malignancies.…”