Germá J R, Izquierdo M A, Seguí M A, Climent M A, Ojeda B, Alonso C
Department of Oncology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma, Barcelona, Spain.
Gynecol Oncol. 1992 May;45(2):153-9. doi: 10.1016/0090-8258(92)90278-q.
From 1979 to 1990, 33 patients with pathologically confirmed malignant ovarian germ cell tumors (MOGCT) were referred after initial surgical procedure at the Department of Oncology, Hospital de la Santa Creu i Sant Pau. The median age was 22 years (range, 10 to 39). Stage distribution was as follows: stage I, 12 patients; stage II, 6 patients; stage III, 11 patients; stage IV, 3 patients; and unstaged, 1 patient. The histologic diagnoses were 10 dysgerminomas, 4 endodermal sinus tumors, 11 immature teratomas, and 8 mixed germ cell tumors. Twenty-eight out of the thirty-three patients received postoperative chemotherapy with POMB-ACE-PAV or other platinum-containing regimens. One patient with stage IV disease failed to respond to chemotherapy and she died. Sixteen out of the twenty-eight treated patients had second-look laparotomy, which showed mature teratoma in six and persistent malignant teratoma in one patient. This last patient had complete remission with second regimen. No patient has developed recurrence. With a median follow-up of 66 months (range, 10 to 133), 32 patients (97%) are alive without evidence of disease. These data confirm that platinum-containing regimens have dramatically improved the prognosis for patients with MOGCT. This paper discusses primary chemotherapy and the role of the second-look in these patients.
1979年至1990年期间，33例经病理确诊的卵巢恶性生殖细胞肿瘤（MOGCT）患者在圣十字圣保罗医院肿瘤科完成初次手术后前来就诊。中位年龄为22岁（范围10至39岁）。分期分布如下：Ⅰ期12例患者；Ⅱ期6例患者；Ⅲ期11例患者；Ⅳ期3例患者；未分期1例患者。组织学诊断为10例无性细胞瘤、4例内胚窦瘤、11例未成熟畸胎瘤和8例混合性生殖细胞肿瘤。33例患者中有28例接受了POMB-ACE-PAV或其他含铂方案的术后化疗。1例Ⅳ期疾病患者化疗无效死亡。28例接受治疗的患者中有16例行二次剖腹探查术，其中6例显示为成熟畸胎瘤，1例显示为持续性恶性畸胎瘤。最后1例患者采用第二种方案后完全缓解。无患者复发。中位随访66个月（范围10至133个月），32例患者（97%）存活且无疾病证据。这些数据证实含铂方案显著改善了MOGCT患者的预后。本文讨论了这些患者的初始化疗及二次探查的作用。
