Need for risk-adapted therapy for malignant ovarian germ cell tumors: A large multicenter analysis of germ cell tumors' patients from French TMRG network - Centre Alexis Vautrin Accéder directement au contenu
Article Dans Une Revue Gynecologic Oncology Année : 2020

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

1 Hôpital Yves LE FOLL [Saint-Brieuc]
2 Institut Bergonié [Bordeaux]
3 CARIO - Centre Armoricain de Radiothérapie, d'Imagerie médicale et d'Oncologie [Plérin, Saint-Brieuc]
4 CRLCC - CRLCC Eugène Marquis
5 CHU Tenon [AP-HP]
6 SU - Sorbonne Université
7 Hôpital Cochin [AP-HP]
8 IGR - Institut Gustave Roussy
9 Oncologie gynécologique
10 Institut Claudius Regaud
11 HEGP - Hôpital Européen Georges Pompidou [APHP]
12 Hôpital Bretonneau
13 Centre Léon Bérard [Lyon]
14 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
15 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
16 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
17 Groupe Hospitalier Diaconesses Croix Saint-Simon
18 CHU de Poitiers - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
19 HUS - Les Hôpitaux Universitaires de Strasbourg
20 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
21 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
22 UNICANCER/CJP - Centre Jean Perrin [Clermont-Ferrand]
23 IMoST - Imagerie Moléculaire et Stratégies Théranostiques
24 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
25 UNICANCER/Lille - Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]
26 Hôpital Dupuytren [CHU Limoges]
27 IPC - Institut Paoli-Calmettes
28 ICM - UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle
29 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
30 Hôpital privé du Confluent [Nantes]
J. Edeline
  • Fonction : Auteur
M. Cancel
  • Fonction : Auteur
T. de La Motte Rouge
  • Fonction : Auteur correspondant

Résumé

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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Dates et versions

hal-02909552 , version 1 (08-09-2022)

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Paternité - Pas d'utilisation commerciale

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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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