Re: ‘Can we replace adjuvant chemotherapy with surveillance for stage IA-C immature ovarian teratomas of any grade? An international multicenter analysis’

Abstract

The article by Bergamini et al. [ [1] Bergamini A. Sarwar N. Ferrandina G. Scarfone G. Short D. Aguiar X. et al. Can we replace adjuvant chemotherapy with surveillance for stage IA-C immature ovarian teratomas of any grade? an international multicenter analysis. Eur J Canc. 2020; 137: 136-143 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar ] adds to the growing body of evidence supporting surveillance, rather than adjuvant chemotherapy, in the postoperative management of ovarian immature teratomas (IT). Postop surveillance is established for paediatric IT [ 2 Billmire D.F. Cullen J.W. Rescorla F.J. Davis M. Schlatter M.G. Olson T.A. et al. Surveillance after initial surgery for pediatric and adolescent girls with stage I ovarian germ cell tumors: report from the Children’s Oncology Group. J Clin Oncol. 2014; 32: 465-470 Crossref PubMed Scopus (78) Google Scholar , 3 Cushing B. Giller R. Ablin A. Cohen L. Cullen J. Hawkins E. et al. Surgical resection alone is effective treatment for ovarian immature teratoma in children and adolescents: a report of the pediatric oncology group and the children’s cancer group. Am J Obstet Gynecol. 1999; 181: 353-358 Abstract Full Text Full Text PDF PubMed Scopus (126) Google Scholar , 4 Mangili G. Sigismondi C. Lorusso D. Pignata S. Surveillance policy for stage IA malignant ovarian germ cell tumors in children and young adults. J Clin Oncol. 2014; 32: 2814-2815 Crossref PubMed Scopus (9) Google Scholar , 5 Pashankar F. Hale J.P. Dang H. Krailo M. Brady W.E. Rodriguez-Galindo C. et al. Is adjuvant chemotherapy indicated in ovarian immature teratomas? A combined data analysis from the Malignant Germ Cell Tumor International Collaborative. Cancer. 2016; 122: 230-237 Crossref PubMed Scopus (63) Google Scholar ] yet international guidelines continue to recommend adjuvant chemotherapy for nearly all adults [ [6] Ray-Coquard I. Morice P. Lorusso D. Prat J. Oaknin A. Pautier P. et al. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018; 29: iv1-iv18 Abstract Full Text Full Text PDF Scopus (75) Google Scholar , [7] NCCN clinical practice guidelines in oncology. 2017 Google Scholar ]. The authors highlight studies suggesting that postoperative surveillance may also be safe for adult patients [ [8] Bonazzi C. Peccatori F. Colombo N. Lucchini V. Cantu M.G. Mangioni C. Pure ovarian immature teratoma, a unique and curable disease: 10 years’ experience of 32 prospectively treated patients. Obstet Gynecol. 1994; 84: 598-604 PubMed Google Scholar ], particularly in stage I disease [ [9] Mangili G. Scarfone G. Gadducci A. Sigismondi C. Ferrandina G. Scibilia G. et al. Is adjuvant chemotherapy indicated in stage I pure immature ovarian teratoma (IT)? A multicentre Italian trial in ovarian cancer (MITO-9). Gynecol Oncol. 2010; 119: 48-52 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar ], but rightly point out that clinical evidence is extremely sparse. Can we replace adjuvant chemotherapy with surveillance for stage IA-C immature ovarian teratomas of any grade? an international multicenter analysisEuropean Journal of CancerVol. 137PreviewThe role of surveillance after surgery for stage IA-C grade 2 (G2) or grade 3 (G3) immature teratomas (ITs) is controversial with many guidelines advocating adjuvant chemotherapy. Here, we investigate the safety of surveillance in stage IA-C G1-3 ITs. Full-Text PDF Response to letter entitled: Re: Can we replace adjuvant chemotherapy with surveillance for stage IA-C immature ovarian teratomas of any grade? An international multicenter analysisEuropean Journal of CancerVol. 152PreviewWe have read with interest the letter to you from Dr Lockley and colleagues [1] published in response to our manuscript entitled ‘Can we replace adjuvant chemotherapy with surveillance for stage IA-C immature ovarian teratomas of any grade? an international multicenter analysis’ that supports surveillance rather than adjuvant chemotherapy in stage I immature teratomas (ITs). This paper was based on the evaluation of the outcomes of 108 patients with pure ITs, as a result of an international collaboration [2]. Full-Text PDF