Pure dysgerminoma of the ovary in childhood: treatment results and sequelae.

Abstract

Thirty-five children with pure dysgerminoma of the ovary were all treated at the Institut Gustave Roussy (IGR) from 1956-1985. The median follow-up is 8.5 years. The crude 5-year survival rate is 94.1% (+/- 4.1). The disease-free 5-year survival rate is 81.8% (+/- 6.7). Fourteen patients who had stage I disease were treated by unilateral salpingooophorectomy and prophylactic radiotherapy (20 Gy) to ipsilateral iliac, lumbar-aortic, and subclavicular lymph nodes. All are alive without sequelae. Eighteen patients with stage II and III disease were treated by surgery and radiotherapy (30-40 Gy) to the tumor volume. All are alive but radio-induced sequelae are severe. Five relapses of stage I, II, and III tumors occurred and were cured by a second line treatment. Two of the three patients with stage IV disease died. Four patients received a cisplatinum-containing regimen for disseminated disease or because of a relapse before radiotherapy. Three achieved a complete response of measurable tumor. Given the high efficacy of this kind of chemotherapy and the severe sequelae induced by abdomino-pelvic irradiation, we propose initial chemotherapy for widespread disease and radiotherapy in the event of residual tumor.