TY - JOUR T1 - Outcome and Risk Factors for Recurrence in Malignant Ovarian Germ Cell Tumors: A MITO-9 Retrospective Study JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1414 LP - 1421 DO - 10.1097/IGC.0b013e3182236582 VL - 21 IS - 8 AU - Giorgia Mangili AU - Cristina Sigismondi AU - Angiolo Gadducci AU - Gennaro Cormio AU - Paolo Scollo AU - Saverio Tateo AU - Gabriella Ferrandina AU - Stefano Greggi AU - Massimo Candiani AU - Domenica Lorusso Y1 - 2011/11/01 UR - http://ijgc.bmj.com/content/21/8/1414.abstract N2 - 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. ER -