The authors performed a retrospective analysis of women with NDOGCT managed during the period 1970-1994 at the Royal Marsden Hospital and other hospitals of the London Gynaecological Oncology Group.
RESULTS: Sixty-nine women were included; their median follow-up was 5.7 years (minimum, 12 months). The median age was 21 years (range, 4-44 years), with a histology of
immature teratoma (IT) for 17 patients,
endodermal sinus tumor (EST) for 20 patients, and mixed
tumors for 32 patients. Thirty-five patients (51%) had Stage I disease. Nine patients with Stage I
tumors were observed without further
therapy (six with IT and three with mixed
tumors), and one relapsed. Seven patients received non-
platinum-based
chemotherapy, and four relapsed. A total of 52 patients were treated with
platinum-based
chemotherapy, with relapse free and overall survival rates of 87% (95% confidence interval [CI], 73-93%) and 84% (95% CI, 70-91%), respectively. Of these patients, relapse was seen in 0 of 9 IT patients, 1 of 25 patients with mixed
tumors, and 6 of 18 EST patients. With
alpha-fetoprotein (AFP) > 1000 kU/L, relapse was seen in 6 of 18 patients compared with 1 of 33 relapses with lower AFP levels. In multivariate analysis, including all patients who received
chemotherapy, AFP >1000 kU/L (P = 0.001) and non-
platinum-based
chemotherapy (P = 0.005) were associated with relapse. When only patients given
platinum-based treatment were considered, EST histology (P = 0.003) and AFP >1000 kU/L (P = 0.003) were associated with relapse in univariate analysis; however, these factors were linked. No malignant
tumor was found at
second-look surgery performed on 24 patients. Of 26 women assessable for fertility, 24 subsequently recommenced regular menstrual function, and 11 patients had pregnancies.
CONCLUSIONS: