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 analysis

Abstract

We have read with interest the letter to you from Dr Lockley and colleagues [ [1] Lockley M, Stoneham S, Shamash J, et al. Letter re: ‘Can we replace adjuvant chemotherapy with surveillance for stage IA-C immature ovarian teratomas of any grade? an international multicenter analysis’. Google Scholar ] 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] Bergamini A. Sarwar N. Ferrandina G. 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 Sep; 137 (Epub 2020 Aug 4): 136-143https://doi.org/10.1016/j.ejca.2020.06.033 Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar ]. Dr Lockley and colleagues have previously published an interesting retrospective series on a diverse set of patients with malignant ovarian germ-cell tumours (MOGCTs) including 42 ITs [ [3 ] Newton C. Murali K. Ahmad A. et al. A multicentre restrospective cohort study of ovarian germ cell tumors: evidence for chemotherapy de-escalation and alignment of pediatric and adult practice. Eur J Canc. 2019; 113: 19-27 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar ]. Their and other retrospective analyses found that disease recurrence was not significantly reduced by adjuvant chemotherapy in this patient setting, although patient numbers were low [ 3 Newton C. Murali K. Ahmad A. et al. A multicentre restrospective cohort study of ovarian germ cell tumors: evidence for chemotherapy de-escalation and alignment of pediatric and adult practice. Eur J Canc. 2019; 113: 19-27 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar , 4 Mangili G. Scarfone G. Gadducci A. 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 (50) Google Scholar , 5 Pashankar F. Hale J.P. Dang H. 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 (68) Google Scholar ]. 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 Re: ‘Can we replace adjuvant chemotherapy with surveillance for stage IA-C immature ovarian teratomas of any grade? An international multicenter analysis’European Journal of CancerVol. 152PreviewThe article by Bergamini et al. [1] 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 [2–5] yet international guidelines continue to recommend adjuvant chemotherapy for nearly all adults [6,7]. The authors highlight studies suggesting that postoperative surveillance may also be safe for adult patients [8], particularly in stage I disease [9], but rightly point out that clinical evidence is extremely sparse. Full-Text PDF