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Malignant ovarian germ-cell tumours.

Jeffrey J H Low¹, Arunachalam Ilancheran, Joseph S Ng

¹Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology National University Hospital, NUHS Tower Block, Singapore, Singapore. Jeffrey_Low@nuhs.edu.sg

Best Practice & Research. Clinical Obstetrics & Gynaecology

|February 4, 2012

Summary

Malignant ovarian germ-cell tumors are rare and treatable with fertility-sparing surgery and chemotherapy. Most young women retain normal menstrual function and fertility after treatment for these ovarian cancers.

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Area of Science:

Gynecologic Oncology
Reproductive Endocrinology

Background:

Malignant ovarian germ-cell tumors (GCTs) constitute approximately 5% of ovarian malignancies.
These tumors predominantly affect adolescents and young women, are typically unilateral, and highly responsive to chemotherapy.

Purpose of the Study:

To review the surgical and chemotherapeutic management of malignant ovarian GCTs.
To assess the impact of conservative management on fertility and reproductive outcomes in affected women.

Main Methods:

Review of literature on surgical approaches and adjuvant chemotherapy for malignant ovarian GCTs.
Analysis of studies evaluating ovarian function, menstrual recovery, and fertility rates post-treatment.

Main Results:

Fertility-sparing unilateral salpingo-oophorectomy is recommended for early-stage, unilateral disease.
Bleomycin, etoposide, and cisplatin (BEP) chemotherapy is the standard adjuvant treatment.
Conservative management demonstrates excellent prognosis, with high rates of return to normal menstrual function and successful fertility, without increased teratogenicity risk.

Conclusions:

Malignant ovarian GCTs in young women can be effectively managed with fertility-preserving strategies.
Conservative surgery combined with BEP chemotherapy offers excellent oncologic and reproductive outcomes.