Abstract
e15548 Background: Nonepithelial ovarian malignancies account for approximately 10% of all ovarian cancers. Germ cell tumors (GCTs) represent 5% of all ovarian neoplasms and sex cord stromal tumors (SCSTs) are rare neoplasms that account for 3%–5% of them. The aim of this study was to review treatment outcomes in patients (pts) with malignant nonepithelial ovarian cancer in a single institution. Methods: Data from all pts with nonepithelial ovarian cancer sequentially diagnosed and treated at Instituto do Câncer do Estado de São Paulo (ICESP) from 1992 to 2006 were retrospectively reviewed. Results: 38 pts were identified. Median age was 52 y (22-82) for SCTCs and 20 y (12-49) for GCTs. Twelve pts (31.6%) had granulosa cell tumors, 8 (21.1%) immature teratomas, 7 (18.4%) dysgerminomas, 4 (10.5%) endodermal sinus tumors, 3 (7.9%) Sertoli–Leydig cell tumors and 1 (2.6%) embryonal carcinoma. Pts were staged according to FIGO system and 17 (54.8%) were classified as stage I, 3 (9.7%) stage II, 9 (29%) stage III, and 2 (6.5%) stage IV. Surgery was performed in all pts: pan-hysterectomy in 51.5% (17 pts) and unilateral salpingo-oophorectomy or oophorectomy for fertility preservation in 7 (21.2%) and 8 pts (24.2%), respectively; omentectomy in 19 pts (63.3%) and lymphadenectomy in 8 pts (27.6%). Considered as having a high recurrence risk, 37 pts (97.4%) received platinum-based chemotherapy: 17 GCT pts and 14 SCTC pts with adjuvant (n = 31, 83.8%) and 6 pts with palliative intent (n = 6, 16.2%). Twenty-eight pts (75.7%) received BEP regimen and 8 pts (21.6%) were treated with carboplatin and etoposide. At a median follow-up of 4.2 y, 7 pts (18.4%) experienced disease recurrence (3 GCTs and 4 SCTCs) and 24 pts (94.7%) remained alive. One death was observed among GCT pts. The 5-year overall survival rate was 95%. Conclusions: In this high-recurrence-risk group of nonepithelial ovarian cancers, aggressive treatment with surgery and platinum- based chemotherapy resulted in excellent survival outcomes. No significant financial relationships to disclose.
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