Tailored therapy and long-term surveillance of malignant germ cell tumors in the female genital system: 10-year experience

다국어 초록 (Multilingual Abstract)

Objective: To explore the appropriate treatment of malignant germ cell tumor (MGCT) in thefemale genital system, and to analyze the factors influencing both therapeutic response andsurvival outcome.
Methods: A cohort of 230-Chinese women diagnosed with MGCT of the genital systemwas retrospectively reviewed and prospectively followed. The demographic and pathologicalfeatures, extent of disease and surgery, treatment efficiency, recurrence and survival wereanalyzed.
Results: MGCTs from different genital origins shared a similar therapeutic strategy andresponse, except that all eight vaginal cases were infantile yolk sac tumors. The patients’ curerate following the initial treatment, 5-year overall survival and disease-free survival (DFS)were 85.02%, 95.00%, and 86.00%, respectively. Although more extensive excision couldenhance the remission rate; it did not improve the patients’ survival. Instead, the level of themedical institution, extent of surgery and disease were independent prognostic factors forrelapse (p<0.05). Approximately 20% of patients had recurrent or refractory disease, morethan half of whom were in remission following secondary cytoreductive surgery with salvagechemotherapy.
Conclusion: Fertility-sparing surgery with or without standardized PEB/PVB (cisplatin,etoposide/vincristine, and bleomycin) chemotherapy is applicable for female MGCTsof different origins. Comprehensive staging is not required; nor is excessive debulkingsuggested. Appropriate cytoreduction by surgery and antineoplastic medicine at anexperienced medical institution can bring about an excellent prognosis for these patients.

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