Murugaesu Nirupa, Schmid Peter, Dancey Gairin, Agarwal Roshan, Holden Lydia, McNeish Iain, Savage Philip M, Newlands Edward S, Rustin Gordon J S, Seckl Michael J
Department of Medical Oncology, Charing Cross Hospital, London, United Kingdom.
J Clin Oncol. 2006 Oct 20;24(30):4862-6. doi: 10.1200/JCO.2006.06.2489.
Malignant ovarian germ cell tumors are rare and knowledge about prognostic parameters currently is limited. This study was undertaken to evaluate long-term outcome of patients with malignant ovarian germ cell tumors (MOGCTs) after chemotherapy and to assess prognostic parameters.
A total of 113 patients with stage IC to IV MOGCTs were included into this retrospective study. Patients were treated at two large regional cancer centers between 1977 and 2003.
Ten-year recurrence-free and overall survival rates were 82% and 81%, respectively. A total of 20 patients experienced relapse, all within the first 8 years. Outcome after relapse was poor, with only 10% of patients achieving long-term survival. Univariate and multivariate analyses demonstrated that initial stage of disease (relative risk [RR], 5.96; 95% CI, 3.47 to 10.22; P = .03) and elevation of serum markers beta-human chorionic gonadotropin and alpha-fetoprotein (RR, 3.90; 95% CI, 1.40 to 10.9; P = .009) were significant predictors of overall survival, whereas age at diagnosis was of no prognostic value.
This is the first study to identify stage and tumor markers as prognostic parameters for patients with MOGCTs. This might help to select patients for risk-adapted treatment. There is need for improvement of therapeutic strategies after relapse.
恶性卵巢生殖细胞肿瘤较为罕见，目前关于预后参数的了解有限。本研究旨在评估恶性卵巢生殖细胞肿瘤（MOGCTs）患者化疗后的长期预后，并评估预后参数。
本回顾性研究纳入了113例IC至IV期MOGCTs患者。这些患者于1977年至2003年间在两个大型地区癌症中心接受治疗。
10年无复发生存率和总生存率分别为82%和81%。共有20例患者复发，均在最初8年内。复发后的预后较差，只有10%的患者实现长期生存。单因素和多因素分析表明，疾病的初始分期（相对风险[RR]，5.96；95%CI，3.47至10.22；P = 0.03）以及血清标志物β-人绒毛膜促性腺激素和甲胎蛋白升高（RR，3.90；95%CI，1.40至10.9；P = 0.009）是总生存的显著预测因素，而诊断时的年龄无预后价值。
这是第一项将分期和肿瘤标志物确定为MOGCTs患者预后参数的研究。这可能有助于选择适合风险调整治疗的患者。复发后治疗策略需要改进。
