Chow S N, Yang J H, Lin Y H, Chen Y P, Lai J I, Chen R J, Chen C D
Department of Obstetrics and Gynaecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Int J Gynaecol Obstet. 1996 May;53(2):151-8. doi: 10.1016/0020-7292(96)02657-4.
Fifty patients with malignant ovarian germ cell tumors, which accounts for 10.8% of all ovarian malignancies, were treated from 1977 through 1994. Their cases are reviewed.
The histology includes endodermal sinus tumor (EST) in 15 patients, immature teratoma in 14, dysgerminoma in 13, and mixed germ cell tumor in eight. The mean age at presentation was 21.5 years and mean primary tumor diameter was 16 cm. All patients underwent surgery as the initial treatment, and 10 received more than one operation. Postoperative adjuvant chemotherapy was not given to cases with stage Ia immature teratoma and dysgerminoma. VAC (vincristine, actinomycin D, cyclophosphamide) and BVP (bleomycin, vinblastine, cisplatin) regimens were utilized in early 1980s for EST and advanced-stage tumors of immature teratoma and dysgerminoma. BEP (bleomycin, etoposide, cisplatin) and EP (etoposide, cisplatin) regimens were applied in advanced-stage disease and some stage I disease since 1990. VIP (VP-16, ifosfamide, cisplatin) regimen was employed as salvage regimen in cases where other combinations failed.
alpha-Fetoprotein (AFP) was elevated in every tumor containing endodermal sinus element, and AFP served as a good indicator for prediction of tumor recurrence. The follow-up time ranged from 5 to 144 months with the mean of 54.5 months.
The survival rate for EST was 54%, that for immature teratoma and dysgerminoma was 85% and 90%, respectively.
1977年至1994年期间，共治疗了50例恶性卵巢生殖细胞肿瘤患者，占所有卵巢恶性肿瘤的10.8%。现对其病例进行回顾。
组织学类型包括15例内胚窦瘤（EST）、14例未成熟畸胎瘤、13例无性细胞瘤和8例混合性生殖细胞肿瘤。就诊时的平均年龄为21.5岁，原发肿瘤平均直径为16cm。所有患者均接受手术作为初始治疗，其中10例接受了不止一次手术。Ia期未成熟畸胎瘤和无性细胞瘤患者术后未接受辅助化疗。20世纪80年代初，EST以及未成熟畸胎瘤和无性细胞瘤的晚期肿瘤采用VAC（长春新碱、放线菌素D、环磷酰胺）和BVP（博来霉素、长春花碱、顺铂）方案。自1990年起，晚期疾病和部分I期疾病采用BEP（博来霉素、依托泊苷、顺铂）和EP（依托泊苷、顺铂）方案。VIP（VP-16、异环磷酰胺、顺铂）方案用于其他联合方案失败的挽救治疗。
每个含有内胚窦成分的肿瘤中α-甲胎蛋白（AFP）均升高，AFP是预测肿瘤复发的良好指标。随访时间为5至144个月，平均为54.5个月。
EST的生存率为54%，未成熟畸胎瘤和无性细胞瘤的生存率分别为85%和90%。
