@article {Mangili1414, author = {Giorgia Mangili and Cristina Sigismondi and Angiolo Gadducci and Gennaro Cormio and Paolo Scollo and Saverio Tateo and Gabriella Ferrandina and Stefano Greggi and Massimo Candiani and Domenica Lorusso}, title = {Outcome and Risk Factors for Recurrence in Malignant Ovarian Germ Cell Tumors: A MITO-9 Retrospective Study}, volume = {21}, number = {8}, pages = {1414--1421}, year = {2011}, doi = {10.1097/IGC.0b013e3182236582}, publisher = {BMJ Specialist Journals}, abstract = {Aims: This study aimed to investigate the outcome of patients with malignant ovarian germ cell tumors (MOGCTs) and to define the risk factors for recurrence.Methods: A total of 123 patients with MOGCTs were retrospectively reviewed among MITO centers. Eighty-one patients had primary treatment in a MITO center, whereas the other 42 were referred for adjuvant chemotherapy or recurrence. The clinicopathologic characteristics were evaluated for association with relapse or death.Results: Median age was 24 years (range, 11-76 years). Forty-nine (39.8\%) had dysgerminomas, 35 (28.5\%) had immature teratomas, 12 (9.8\%) had mixed germ cell tumors, 26 (21.1\%) had yolk sac tumors, and 1 (0.8\%) had embryonal carcinoma. International Federation of Gynecology and Obstetrics stage distribution was as follows: stage I, 87 (70.7\%); stage II, 3 (2.4\%); stage III, 29 (23.6\%); and stage IV, 4 (3.3\%). Fertility-sparing surgery was performed in 92 patients, whereas the remaining 31 received radical surgery; 65.8\% of patients received adjuvant chemotherapy. Recurrence rate was 17.8\% and the median time to recurrence was 9 months. Univariate and multivariate analyses showed that patient age (\>45 years) and treatment outside a referral (MITO) center were the most important predictors of recurrence. The 5-year overall survival rate was 88.8\%, with a median follow-up of 61 months. Univariate and multivariate analyses demonstrated that stage greater than I and yolk sac tumors were independent poor prognostic indicators.Conclusions: This study confirms that MOGCTs have excellent prognosis, with 5-year overall survival rates of 95.6\% and 73.2\% in stage I and advanced stages, respectively. Age older than 45 years and treatment not in a referral center are independent risk factors for recurrence, whereas stage greater than I and yolk sac histology are independent poor prognostic indicators.}, issn = {1048-891X}, URL = {https://ijgc.bmj.com/content/21/8/1414}, eprint = {https://ijgc.bmj.com/content/21/8/1414.full.pdf}, journal = {International Journal of Gynecologic Cancer} }