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dc.contributor.authorFaure Conter, Cecileen
dc.contributor.authorXia, Caihongen
dc.contributor.authorGershenson, Daviden
dc.contributor.authorHurteau, Jeanen
dc.contributor.authorCovens, Alen
dc.contributor.authorPashankar, Farzanaen
dc.contributor.authorKrailo, Marken
dc.contributor.authorBillmire, Deborahen
dc.contributor.authorPatte, Catherineen
dc.contributor.authorFresneau, Briceen
dc.contributor.authorShaikh, Furqanen
dc.contributor.authorStoneham, Saraen
dc.contributor.authorNicholson, Jamesen
dc.contributor.authorMurray, Matthewen
dc.contributor.authorFrazier, Anne Lindsayen
dc.date.accessioned2019-02-16T00:30:22Z
dc.date.available2019-02-16T00:30:22Z
dc.date.issued2018-01en
dc.identifier.issn1048-891X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/289475
dc.description.abstractBACKGROUND: 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.
dc.format.mediumPrinten
dc.languageengen
dc.subjectHumansen
dc.subjectEndodermal Sinus Tumoren
dc.subjectOvarian Neoplasmsen
dc.subjectNeoplasm Stagingen
dc.subjectPrognosisen
dc.subjectAge Factorsen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectChilden
dc.subjectChild, Preschoolen
dc.subjectInfanten
dc.subjectInfant, Newbornen
dc.subjectFemaleen
dc.subjectYoung Adulten
dc.titleOvarian Yolk Sac Tumors; Does Age Matter?en
dc.typeArticle
prism.endingPage84
prism.issueIdentifier1en
prism.publicationDate2018en
prism.publicationNameInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Societyen
prism.startingPage77
prism.volume28en
dc.identifier.doi10.17863/CAM.36725
dcterms.dateAccepted2017-09-15en
rioxxterms.versionofrecord10.1097/igc.0000000000001149en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-01en
dc.contributor.orcidMurray, Matthew [0000-0002-4480-1147]
dc.identifier.eissn1525-1438
rioxxterms.typeJournal Article/Reviewen
rioxxterms.freetoread.startdate2019-01-31


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