994P - Malignant ovarian germ cell tumors (MOGCT) at a tertiary care setting in Pakistan

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Ovarian Cancer
Presenter Abdul Hannan
Authors A. Hannan1, N. Siddiqui2, F. Badar2
  • 1Medical Oncology, Shaukat Khanum Memorial Cancer Hospital, 54000 - Lahore/PK
  • 2Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Reserch Centre (SKM), 54550 - Lahore/PK

Abstract

Introduction

Malignant ovarian germ cell tumors (MOGCT) are rare neoplasms. Little is known about their behavior in the South East Asian populations. Aim of our study was to evaluate MOGCT patients treated at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.

Patients and methods

Of 638 females identified with ovarian cancer at our hospital from 1994 to 2007, 66 presenting with MOGCT were reviewed retrospectively. Histology was based on WHO classification. Tumors were staged according to FIGO system. Data was collected on presenting age, histopathology, stage, alpha-feto protein (AFP), B-human chorionic gonadotropins (B-hCG) levels, treatment, time to recurrence (TTR) and overall survival (OS). OS was the interval between the dates of diagnosis and last visit / death and TTR was between the dates of diagnosis and first recurrence. OS was determined by the Kaplan Meier method. Seven patients were not included in survival analysis as they were lost to follow up.

Results

Mean presenting age: 18.1 years (6-45). Stage wise distribution (n): Stage 1 (19), II (8), III (21), IV (18). Histology (n): Dysgerminoma (22), malignant teratoma (16), yolk sac tumor (15), Mixed germ cell (12) and embryonic carcinoma in 1 patient only. AFP levels (n): elevated (29), normal (25) while unknown in 12 patients. B-hCG levels (n): elevated n = 15, normal n = 42 and unknown in 9. Median follow up time was 48 months (0.2-183). All patients underwent initial surgery, with 20 patients undergoing second look surgeries. Fertility sparing procedures were performed in 57 % of patients. Thirty four patients (57 %) achieved a complete remission at the end of treatment; while 18 (27.2%) patients did not show a response to any chemotherapy and had progressive disease. Seven patients relapsed, all within the first 3 years. The TTR was 11.2-32.5 months. Cumulative overall survival: 60 months. 16 (88 %) of stage 1 patients while only 4 (26.6 %) of stage IV patients were alive at median follow up.

Conclusions

The prognosis of MOGCT appears to be good and results are similar to what has been seen in the west. Fertility sparing surgery was possible in majority of cases and its feasibility should be explored in this young population of patients.

Disclosure

All authors have declared no conflicts of interest.