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Need for risk-adapted therapy for malignant ovarian germ cell tumors: A large multicenter analysis of germ cell tumors' patients from French TMRG network

F. Derquin 1 A. Floquet 2 A.C. Hardy-Bessard 3 J. Edeline 4 J.P. Lotz 5, 6 J. Alexandre 7 P. Pautier 8, 9 M.A. Angeles 10 N. Delanoy 11 C. Lefeuvre-Plesse 4 M. Cancel 12 I. Treilleux 13 P. Augereau 14 V. Lavoue 15 E. Kalbacher 16 D. Berton Rigaud 14 F. Selle 17 C. Nadeau 18 J. Gantzer 19 F. Joly 20 C. Guillemet 21 C. Pomel 22 L. Favier 23 C. Abdeddaim 24 L. Venat-Bouvet 25 M. Provansal 26 M. Fabbro 27 M.C. Kaminsky 28 A. Lortholary 29 F. Lécuru 11 I Ray Coquard 13 T. de La Motte Rouge 4, * 
* Corresponding author
9 Oncologie gynécologique
Département de médecine oncologique [Gustave Roussy]
Abstract : Background - Malignant ovarian germ cell tumors are rare tumors, affecting young women with a generally favorable prognosis. The French reference network for Rare Malignant Gynecological Tumors (TMRG) aims to improve their management. The purpose of this study is to report clinicopathological features and long-term outcomes, to explore prognostic parameters and to help in considering adjuvant strategy for stage I patients. Patients and methods - Data from patients with MOGCT registered among 13 of the largest centers of the TMRG network were analyzed. We report clinicopathological features, estimated 5-year event-free survival (5y-EFS) and 5-year overall survival (5y-OS) of MOGCT patients. Results - We collected data from 147 patients including 101 (68.7%) FIGO stage I patients. Histology identifies 40 dysgerminomas, 52 immature teratomas, 32 yolk sac tumors, 2 choriocarcinomas and 21 mixed tumors. Surgery was performed in 140 (95.2%) patients and 106 (72.1%) received first line chemotherapy. Twenty-two stage I patients did not receive chemotherapy. Relapse occurred in 24 patients: 13 were exclusively treated with upfront surgery and 11 received surgery and chemotherapy. 5y-EFS was 82% and 5y-OS was 92.4%. Stage I patients who underwent surgery alone had an estimated 5y-EFS of 54.6% and patients receiving adjuvant chemotherapy 94.4% (P < .001). However, no impact on estimated 5y-OS was observed: 96.3% versus 97.8% respectively (P = .62). FIGO stage, complete primary surgery and post-operative alpha fetoprotein level significantly correlated with survival. Conclusion - Adjuvant chemotherapy does not seem to improve survival in stage I patients. Active surveillance can be proposed for selected patients with a complete surgical staging.
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https://hal.archives-ouvertes.fr/hal-02909552
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Submitted on : Thursday, September 8, 2022 - 3:23:14 PM
Last modification on : Monday, November 28, 2022 - 10:38:07 AM

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F. Derquin, A. Floquet, A.C. Hardy-Bessard, J. Edeline, J.P. Lotz, et al.. Need for risk-adapted therapy for malignant ovarian germ cell tumors: A large multicenter analysis of germ cell tumors' patients from French TMRG network. Gynecologic Oncology, 2020, 158 (3), pp.666-672. ⟨10.1016/j.ygyno.2020.06.491⟩. ⟨hal-02909552⟩

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