Outcome and Prognostic Factors in Ovarian Germ Cell Malignancies

Outcome and Prognostic Factors in Ovarian Germ Cell Malignancies.

According to the results of a study recently published in Gynecologic Oncology, the prognosis for ovarian germ cell malignancies (OGCMs) is excellent if patients are managed with standard treatment initially.

Ovarian cancer is a malignancy that arises from various different cells within the ovaries. Approximately 25,000 new cases of ovarian cancer are diagnosed in the United States each year. Germ cell tumors arise from the cells that are destined to become eggs within the ovaries. Unfortunately, ovarian cancer often goes undetected until the disease has progressed into the abdomen or spread to other organs. The best treatment strategy for cancer is to prevent its occurrence or to detect it early when it is most treatable. Treating advanced ovarian cancer is often difficult and results in poor outcomes. Many patients often have recurrent disease after they have completed treatment. This has prompted a great deal of research to identify ways of treating ovarian cancer and improving the overall outcomes.

Researchers in this recent study sought to determine the outcomes and prognostic factors in patients with OGCMs. A total of 93 patients diagnosed with OGCM were enrolled, 84 of whom had already received primary treatment. The remaining 9 patients were referred to outside sources for treatment and were then assigned to one of the following: follow-up (1 patient), continued chemotherapy (4 patients), or salvage chemotherapy when the disease recurred (4 patients). The treatment related characteristics, presentation, and pathology were analyzed for association with the occurrence of tumor recurrence/persistence and death.

Results of the study indicated that the average follow-up of survivors was 66 months. The average time to disease recurrence or progression was 8 months. Of the 93 patients, 11 were considered treatment failures and 6 of these patients died. The 5-year survival rate was 97% for the patients who received primary treatment initially compared to those who had been referred to outside sources for treatment. Further pathology analysis revealed that certain cell types were associated with treatment failures. Factors that impacted the patients overall survival included the cell type, treatment with high-dose chemotherapy, and remaining tumor after surgery.

Researchers concluded that standard treatment at the time of diagnosis improves survival for patients diagnosed with OGCMs. More aggressive management is needed for recurrent or persistent disease following primary treatment. Patients are encouraged to speak to their physician regarding treatment options for their specific situation.

Reference: Lai C, Chang T, Hush S, et al. Outcome and Prognostic Factors in Ovarian Germ Cell Malignancies. Gynecologic Oncology. 2005;96: 784-791.

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