Therapy of ovarian malignant germ cell tumors and granulosa tumors.

High-dose cisplatin-based chemotherapy is highly effective in all cases of germ cell tumors, including dysgerminoma. The complete remission and cure rates are between 80 and 90% of all cases. In young women, fertility-preserving surgery can be recommended. This is true for stage III cases as well because removal of the second ovary and the uterus does not change the prognosis. For granulosa cell tumors, however, meticulous surgery is the primary therapy. Operation should include careful pelvic and para-aortic lymph-adenectomy. Better knowledge of disease spread, improved surgical staging, the use of alphafetoprotein and human chorionic gonadotropin immunoassays to monitor therapy, and the ability of chemotherapy to treat advanced and recurrent cases successfully have changed the recommendations for therapy of germ cell and granulosa cell tumors.