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Pediatric Surgery International
Published in: Pediatric Surgery International 9/2020

01-09-2020 | Cytostatic Therapy | Original Article

Surgical resection and outcome of malignant ovarian germ cell tumors in children—a national multicentric study compared to international results

Authors: Ahmed Elgendy, Mahmoud Mostafa, Mohamed Abouelmagd Salem, Amany Ali, Ahmed Khairi, Sameh Shehata

Published in: Pediatric Surgery International | Issue 9/2020

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Abstract

Purpose

To evaluate the outcome of pediatric malignant ovarian germ cell tumors treated by three tertiary Egyptian institutions, and to compare our national experience to internationally published data.

Methods

This is a retrospective analysis of all patients presenting between September 2014 and September 2019. Management protocol was Children's Oncology Group (COG) in all participating centers. Overall survival (OS), event-free survival (EFS) and univariate prognostic factors were estimated by Kaplan–Meier and log-rank test. Additionally, a review of various practices that reported survival outcome was conducted.

Main results

Thirty-seven patients were included with a median age of 10.5 years (1–18 years). Thirty-five patients had unilateral salpingo-oophorectomy. Mixed germ cell and yolk sac tumors represented 75.7% of patients. There were 7 (19%), 14 (37.8%), 12 (32.4%) and 4 (10.8%) stage I, II, III and IV, respectively. Seven patients were low risk (LR), 26 intermediate risk (IR) and 4 high risk (HR). Platinum-based chemotherapy was administered as per risk stratification. Follow-up to March 2020 revealed that five patients had relapsed. There were no statistical significances of pathological types and patients' age regarding OS (p value 0.392 and 0.281, respectively) and EFS (p value 0.420 and 0.437, respectively). Three-year OS was 84%: 100% for stages I and II, and 62% for stages III and IV (p = 0.003); 100% for LR, 89% for IR, and 24% for HR (p < 0.001). Three-year EFS was 87%: 96% for stages I and II, and 71% for stages III and IV (p = 0.025); 100% for LR, 92% for IR, and 26% for HR (p < 0.001).

Conclusion

Surgical resection combined with chemotherapy achieves excellent outcome for such tumors in both, present study and previous reports. On the basis of our results, COG staging and risk stratification were significantly correlated with prognosis, whereas tumor pathology and age had no significant impact. Prognostic factors are controversial among studies, and further research is still required.
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Metadata
Title
Surgical resection and outcome of malignant ovarian germ cell tumors in children—a national multicentric study compared to international results
Authors
Ahmed Elgendy
Mahmoud Mostafa
Mohamed Abouelmagd Salem
Amany Ali
Ahmed Khairi
Sameh Shehata
Publication date
01-09-2020
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 9/2020
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-020-04716-x

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