Feasibility of Fertility-Sparing Surgery After Neoadjuvant Chemotherapy for Advanced Malignant Germ Cell Tumor of the Ovary

Anjana, J. S.; Suchetha, S.; Rema, P.; Ranjith, J. Siva; Dhar, Dinesh; James, Francis V.; Kumar, Aswin; Krishna, K M Jagathnath

doi:10.1007/s40944-022-00673-6

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…Since the tumors present in young age and are highly chemosensitive tumors, neoadjuvant chemotherapy has been tried in such patients but literature regarding them is scarce. NACT in MOGCT was studied by Talukdar et al [ 2 ] and Anjana et al [ 3 ] with favorable outcome discussed further. Another study by Lu et al [ 4 ] was done exclusively in yolk sac tumor patients.…”

Section: Discussionmentioning

confidence: 99%

“…Anjana et al [ 3 ] studied NACT in 28 patients with 12 patients of yolk sac tumor followed by 10 patients of dysgerminoma and 9 patients had stage 4 disease. Twenty-four patients underwent fertility sparing surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Four pregnancies were noted and 76% resumed menses with 9.5% premenarchal patients. One recurrence was noted with mortality in same patient [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Study of neoadjuvant chemotherapy in advanced malignant ovarian germ cell tumors at a tertiary center in western India

Vasanth,

Patel,

Arora

et al. 2024

J Gynecol Oncol

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Objective To study clinical characters and outcomes in patients of malignant ovarian germ cell tumor (MOGCT) undergoing surgery following neoadjuvant chemotherapy (NACT). Methods Retrospective study of patients undergoing surgery following NACT for MOGCT at our institute. Platinum based chemotherapy was given in all patients in NACT. Results Between March 2013 and February 2023, 30 patients had surgery after NACT. Patient’s median age was 22 years (range, 12 to 35 years) and median follow up 42months (range, 6 to 132 months). Majority had endodermal sinus tumor (n=12), dysgerminoma (n=9) and mixed GCT (n=7). All had either International Federation of Gynecology and Obstetrics (FIGO) stage 3 (n=19) or FIGO stage 4 disease (n=11). Complete response to NACT seen in 5 patients and 23 patients had partial response. Fertility sparing surgery in 18 patients and complete surgery in 12 patients. Suboptimal surgery was seen in 4 patients. Currently, 20 of 30 patients are alive and disease free, 3 lost for follow up and 7 patients had progression after adjuvant therapy. Five patients had mortality—4 with progression and 1 with bleomycin toxicity. Fifteen of 17 eligible patients have resumed menstruation and one had successful pregnancy. Prognostic factors noted in study are stage, optimal surgery and viable tumor in histopathology. Dysgerminoma had better outcome than other histology. Conclusion NACT may be a reasonable option in patients with extensive unresectable disease or in whom fertility sparing is not possible or in the poor general condition. Fertility sparing surgery can be attempted post neoadjuvant chemotherapy without adversely affecting prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%