Current management of ovarian germ cell tumors

Ovarian germ cell tumors, although rare, are important because they occur in young individuals and frequently are fulminant if initial treatment is inadequate. These tumors can be broadly divided into dysgerminomas and nondysgerminomatous tumors, although in reality many tumors are of mixed pathology. Surgical staging is important, and when performed by inexperienced surgeons is often inadequate. However, except for localized purely dysgerminomatous tumors, prompt institution of chemotherapy is more appropriate than repeat exploration to establish more precise staging. Tumors other than dysgerminoma are most often treated with etoposide-containing regimens, and recent studies suggest that patients with dysgerminomas also should be treated primarily with chemotherapy.