Guillem V, Poveda A
Fundación Instituto Valenciano de Oncología, Valencia, Spain.
Clin Transl Oncol. 2007 Apr;9(4):237-43. doi: 10.1007/s12094-007-0045-0.
Germinal cell tumours represent only 2-5% of all cancers of the ovary. However, the characteristics of the tumour and the patients have some special qualities as high rates of healing goes together with a strong desire to keep fertility intact because this condition occurs in female children and adolescent girls. Neither the prognosis nor the treatment of these tumours is homogeneous; the low incidence is the reason it is hard to develop prospective studies for establishing prognostic factors and specific treatments. The introduction of adjuvant chemotherapy into initial surgery has improved the prognosis of these patients. The BEP scheme has proved to be equally efficient and less toxic than PVB, and for this reason it has become the standard scheme despite the fact that no randomised studies have been carried out. The surgical treatment demands the application of the same principles seen in cytoreduction surgery of epithelial cancers of the ovary (maximum possible cytoreduction), though in many cases hysterectomy and double adnexectomy may be obviated. In view of the rarity of these tumours, it is advisable to work within cooperative groups that may have subgroups for the treatment of rare tumours. This will probably be the only way to move forward in the prospective knowledge of prognostic factors for these tumours.
生殖细胞肿瘤仅占卵巢癌总数的2%-5%。然而，该肿瘤及患者具有一些特殊性质，即高治愈率与强烈的保留生育能力的愿望并存，因为这种情况多见于女童和青春期少女。这些肿瘤的预后和治疗都不统一；发病率低是难以开展前瞻性研究以确定预后因素和具体治疗方法的原因。在初始手术中引入辅助化疗改善了这些患者的预后。BEP方案已被证明与PVB方案同样有效且毒性更小，因此尽管尚未进行随机研究，但它已成为标准方案。手术治疗需要应用与卵巢上皮癌细胞减灭术相同的原则（尽可能最大程度地减灭肿瘤细胞），不过在许多情况下，子宫切除术和双侧附件切除术可能可以避免。鉴于这些肿瘤较为罕见，建议在可能设有罕见肿瘤治疗亚组的协作组内开展工作。这可能是在这些肿瘤预后因素的前瞻性认识方面取得进展的唯一途径。
