Malignant ovarian germ cell tumors in adolescents: 18 years of experience at a single institution

Malignant ovarian germ cell tumors (MOGCTs) in adolescents are rare. Although fertility-sparing surgery for such patients is suggested unequivocally, the necessity of staging surgery remains the subject of intense debate. Here, we evaluate the role of staging surgery in adolescents affected by MOGCTs and review the outcomes of these patients. We performed a retrospective study of patients aged 10-19 years who received surgery and were pathologically diagnosed with MOGCTs at OB/GYN Hospital of Fudan University between January 1997 and October 2014. Forty-two patients diagnosed with immature teratomas, dysgerminomas, endodermal sinus tumors and mixed germ cell tumors were included in this study. The majority (90.5%) of them were of apparent early-stage with lesion confined to the ovary grossly, and the majority (90.5%) received adjuvant chemotherapy. Although comprehensive staging protocols were followed in only a small number of patients (28.6%) in our cohort, the recurrence rate was low at 4.8%. Five-year overall survival and disease-free survival were 97.2% and 94.8%, respectively. Comprehensive staging or individual factors such as peritoneal washings cytology, lymph nodes dissection and omentectomy were not independent risk factors for disease-free survival (DFS). Positive peritoneal washing cytology or lymph nodes were not correlated with recurrence. Our findings show that there is a good prognosis for adolescents affected by MOGCTs and for adolescent patients receiving adjuvant chemotherapy, staging procedures may not provide any additional benefits.