Malignant germ cell tumors of the ovary: a review of 41 cases and risk factors for recurrence.

OBJECTIVE: To review the outcome of treatment in patients with malignant ovarian germ cell tumors and to define the risk factors for recurrence. MATERIAL AND METHODS: Forty-one patients with malignant ovarian germ cell tumors were reviewed retrospectively. Survival time and survival rate were obtained. Risk factors such as stage, histological type, and type of operation were evaluated for reccurrence. RESULTS: Twenty-three (56%) had dysgerminomas, eight (19.5%) had mixed germ cell tumors, three (7.3%) had yolk sac tumors, three (7.3%) had immature teratomas, two (4.8%) had squamous cell carcinoma arising from a mature teratoma, one (2.4%) had embryonal carcinoma and one choriocarcinoma. Most of the cases (73%) were in Stage I. Twenty-nine patients (70.7%) underwent conservative surgery and 12 patients (29.3%) had at least bilateral salpingo-oophorectomy. Thirty patients were operated on optimally with surgical staging and 11 suboptimally. Seven patients (17%) had recurrence after remission. The overall survival time was 187 +/- 8.43 months for all cases, 195 +/- 8.49 for dysgerminoma and 161 +/- 10.96 for non-dysgerminoma cases with a median follow-up time of 98.52 (8-204) months. Non-dysgerminoma histologic type, being operated on suboptimally and radically, and advanced tumor stage have been found to be risk factors for recurrence. CONCLUSION: Regardless of histologic types and stages the prognosis of germ cell tumors are satisfactory with current therapeutic strategies.