Chemotherapy of ovarian germ cell tumors.

The development of modern surgical staging and effective chemotherapy regimens has markedly improved outcome of treatment of ovarian germ cell tumors. Almost all patients with completely resected tumors will survive their disease. Those with tumors other than dysgerminoma should all receive adjuvant chemotherapy. Patients with stage IA dysgerminoma can safely be observed, whereas those of higher stage should probably receive chemotherapy, although radiotherapy may be an option in selected patients, particularly older ones or those with other serious illness. Patients with advanced disease should all be treated with chemotherapy. Cisplatin-based regimens as developed for testicular cancer are more effective than VAC or VAC-type regimens. With such treatment, most dysgerminoma patients will be cured, as will many with other cell types. However, there is room for improvement in the latter group and continued investigation is appropriate.