Introduction/Background Malignant ovarian germ cell tumors (MOGCT) are rare but highly chemo-sensitive tumors of young females and are primarily managed with limited surgical staging followed by surveillance or adjuvant chemotherapy in eligible cases. Though there are no formal guidelines indicated for NACT in high-risk candidates for upfront surgery or, the anticipation of visceral- resection, or non-fertility sparing surgery, this approach is often utilized in LMICs like India due to the higher burden of patients presenting in advanced stage. Despite a highly favorable response to NACT in such settings, we encountered a few cases where surgical radicality was high even after optimal cycles of systemic therapy. Unlike epithelial ovarian cancers, there is a dearth of data regarding the predictability of surgical complexity post-NACT in MOGCT.

Methodology This is a retrospective cohort analytical study conducted at a tertiary cancer center, Guwahati. Patients with MOGCT managed with NACT followed by surgery between January 2019 to December 2022 were included. The surgical radicality was assessed using the Aletti score and co-related with various clinicopathological characteristics.

Results On analyzing 26 eligible patients, we found out that 14 (53.8%), 10(38.4%), and 2 (7.6%) patients fell into groups with low, intermediate, and high surgical complexity scores respectively. The surgical radicality was significantly associated with the apparent stage ( p=0.03) and post-NACT response as per RECIST criteria ( p=0.03). The co-relation of surgical radicality with age, performance status, serum tumor markers levels, histology of the tumor, choice of NACT (BEP/EP), and number of cycles of NACT were not statistically significant.

Conclusion The predictive factors for the radicality of the surgery following NACT in MOGCT assist clinicians in making the best decisions for young patients and providing appropriate counseling.

Disclosures Conflict of Interest Disclosure Statement

The European Society of Gynaecological Oncology requires clear disclosures from all presenters at its annual congress regarding any financial holdings, funding sources, or affiliations that might raise questions of bias or be perceived to have potentially influenced presentation content.

Please disclose any financial relationship from the past three years (dating from the month of submission) of any size.