Ovarian Yolk Sac Tumors; Does Age Matter?
Faure Conter, Cecile
Frazier, Anne Lindsay
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
MetadataShow full item record
Faure Conter, C., Xia, C., Gershenson, D., Hurteau, J., Covens, A., Pashankar, F., Krailo, M., et al. (2018). Ovarian Yolk Sac Tumors; Does Age Matter?. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 28 (1), 77-84. https://doi.org/10.1097/igc.0000000000001149
BACKGROUND: Whereas among pediatric oncologists, ovarian yolk sac tumor (O-YST) is considered a chemosensitive tumor, it is often cited as an adverse prognostic factor in adult women with ovarian germ cell tumors. METHODS: The Malignant Germ Cell International Consortium data set included 6 pediatric clinical trials (United States, United Kingdom, and France) and 2 adult gynecology clinical trials (United States). Any patient with an O-YST that was International Federation of Gynecology and Obstetrics stage IC or higher and treated with a platinum-based chemotherapy was eligible. Age was modeled as a continuous and a categorical variable (children, 0-10 years; adolescents, 11-17 years; and adults, ≥18 years). In addition, analyses to establish the optimal cut point for age were conducted. Tumors were coded as pure YST (YST +/- teratoma), mixed YST (YST + other malignant germ cell component), or putative YST ("mixed" germ cell tumor + alpha-fetoprotein >1000 ng/mL). Histology, stage (II/III vs IV), preoperative alpha-fetoprotein levels (<1000; 1000-10,000, or >10,000 ng/mL), and chemotherapeutic regimen (carboplatin vs cisplatin) were analyzed as covariates. RESULTS: Two hundred fifty-one patients (median age, 13 years; range, 0-38 years) were identified (78 children, 139 adolescents, and 34 adults). Histology was pure, mixed, and putative in 129, 56, and 66 cases, respectively. Twenty-six patients had stage IV disease, similarly distributed in the 3 age groups. Median follow-up was 5.8 years. The overall 5-year event-free survival and overall survival was 91% (95% confidence interval, 87%-94%) and 96% (92%-98%), respectively. Age did not affect risk of event or death, modeled either as a categorical or continuous variable. Analysis failed to identify an age cut point that affected risk. None of the other covariates investigated had a prognostic impact on event-free survival or overall survival. CONCLUSIONS: Ovarian yolk sac tumors have an excellent outcome across all age-groups. Age has no apparent impact on the probability of event or death, allowing pediatric and gynecologic oncologists to enroll patients onto joint pediatric and adult trials.
Humans, Endodermal Sinus Tumor, Ovarian Neoplasms, Neoplasm Staging, Prognosis, Age Factors, Adolescent, Adult, Child, Child, Preschool, Infant, Infant, Newborn, Female, Young Adult
External DOI: https://doi.org/10.1097/igc.0000000000001149
This record's URL: https://www.repository.cam.ac.uk/handle/1810/289475