Abstract
Purpose: Malignant ovarian germ cell tumors cause 5% of ovarian cancers. Studies examining prognosis and survival rates are significant due to malignant ovarian germ cell tumors' rarity. We aimed to investigate outcome and prognostic factors in these patients.
 Materials and Methods: The study includes clinicopathological records of malignant ovarian germ cell tumor patients in our clinic between April 1992 and November 2017. Demographic and clinical characteristics, pathological observations, adjuvant treatment modalities, and follow-up details were analyzed, and their survival effects were investigated.
 Results: One hundred fifteen patients with malignant ovarian germ cell tumors were analyzed. Most patients were reproductive-age nulliparous. The patients' mean age was 27.5+14.3, and the mean follow-up was 71.04 months. The research includes 42 dysgerminomas, 37 immature teratomas, 17 mixed germ-cell tumors, 16 endodermal sinus tumors, and three embryonic carcinomas. The disease stage was 1, 2, 3, and 4 in 53%, 16.5%, 25.2%, and 5.2% of patients, respectively.
 Fertility-sparing surgery was conducted in 55 of 79 patients, and 34.5% received pregnancy. Five-year overall survival was 74%. Localization of tumors, non-optimal cytoreduction, advanced-stage disease, poor differentiation, metastasis, and mixed cell histology were determined as poor prognostic factors. In multivariate analyzes, factors affecting disease-free survival are the FIGO stage, mixed germ cell histology, and suboptimal cytoreduction.
 Conclusion: The prognosis of malignant ovarian germ cell tumors is excellent, especially in young, early-stage, and adequately operated patients. FIGO Stage, mixed germ cell histopathology and complete cytoreduction affect the prognosis of MOGCT. Treatment at reproductive age does not significantly affect pregnancy outcomes. Therefore, the fertility sparring approach should be considered a good option, especially in young patients.
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