Non-seminomatous ovarian germ cell tumours in children

In this study, we report the results of two consecutive protocols. TGM 55 and TGM 90, of the Société Fran¿aise d'Oncologie Pédiatrique ( SFOP) for patients with non-seminomatous germ cell tumours of the ovary and analyse the rationale for surgical indications. neoadjuvant or adjuvant chemotherapy. TGM 55 and 90 both utilised six drugs, bleomycin, cyclophosphamide, vinblastine, dactinomycin, etoposide and either cisplatin (TGM 55) or carboplatin TGM 90). Chemotherapy was given in ease of unresectable or incompletely resected tumour. Patients who had a complete resection of a localised tumour underwent expectant management and were only treated if progression occurred. 63 patients aged less than 18 sears old were enrolled between January 1955 and December 1994. 49 patients had alpha-fetoprotein (alphaFP) +/- beta-human chorionic gonadotropic hormone (betaHCG) secreting tumours and 14 had immature teratomas. Median follow-up for surviving patients is 60 months (range: 19-154). The 5-year overall survival is 85% +/- 5%. 13 out of 14 patients (93%) with immature teratoma are alive, including 3 of 4 patients (75%) who received chemotherapy for advanced disease. 41 patients (54%) with secreting tumours are alive, including 2 patients who required salvage treatment. Most failures occurred amongst patients with high initial alphaFP secretion ( > 15,000 ng/ml). 39 of 41 survivors (95%) in thc non-teratoma group had conservative surgery, allowing the possibility of future pregnancy. High cure rate can he achieved with a conservative approach in non-seminomatous germ cell tumour of the ovary. Whenever possible, fertility should he preserved during the primary operation in children suffering from these tumours.