Cisplatin-based chemotherapy in the management of germ cell tumors of the ovary: The Institut Gustave Roussy Experience.

The past two decades have seen great improvements in the diagnosis and management of ovarian germ cell tumors. To assess the impact of cisplatin-based chemotherapy, a retrospective review based on a standardized questionnaire was conducted in 54 patients with malignant germ cell neoplasms of the ovary who received cisplatin-based chemotherapy as part of their first-line or salvage therapy at the Institut Gustave Roussy from September 1980 to December 1992. Chemotherapy was administered as primary postoperative treatment in 40 (75%) patients while 14 patients received chemotherapy as part of their salvage treatment for recurrent disease. With a median follow-up of 6 years, the overall survival is 74%. Twenty-three (96%) of the 24 patients who received chemotherapy in an adjuvant setting are alive without evidence of disease compared to 9 (56%) of 16 and 8 (57%) of 14 who were treated for advanced or recurrent disease, respectively. The long-term toxicity was minimal. Among 22 patients who underwent conservative surgery, 13 resumed normal menstrual function. Four patients delivered 5 healthy children. With male germ-cell tumors as a template, cisplatin-based chemotherapy clearly improves the prognosis for patients with ovarian germ cell tumors, especially in the adjuvant setting.