Outcomes of Pediatric and Adolescent Girls with Malignant Ovarian Germ Cell Tumors after Chemotherapy and Surgery: A Single Institutional Experience.

INTRODUCTION

Malignant ovarian germ cell tumors are rare and vital cancers in the pediatric age group of females, affecting 1-2% of all ovarian malignancies. Advances in surgical management, chemotherapy, and patient care have significantly improved survival.

MATERIALS AND

METHODS

This retrospective study investigates the treatment outcomes of 116 pediatric patients diagnosed with Malignant ovarian germ cell tumors at a tertiary care center in Pakistan between 1999 and 2022. The study focuses on patterns of care, survival rates, recurrence, and complications associated with therapy.

RESULTS

The median age was 13.5 years, with dysgerminomas predominating (38.7%). Most patients had upfront surgery (87.9%), followed by adjuvant chemotherapy, including JEB (Carboplatin, etoposide, bleomycin) (64.7%), BEP (bleomycin, etoposide, cisplatin) (25.0%), and PEB (cisplatin, Etoposide, Bleomycin) (4.3%). The five-year event-free survival (EFS) and overall survival (OS) were 87.1% and 90.5%, respectively. Histology, chemotherapy regimen, and risk group classification were key factors influencing survival, with dysgerminoma showing the best prognosis. In patients whose tumor markers normalized rapidly, event-free survival (EFS) was better. Relapsed disease was observed in 2.6% of patients, and disease progression occurred in 7.8%.

CONCLUSION

Our study shows good outcomes for girls with ovarian tumors. This study highlights the effectiveness of multimodal treatment strategies, including both surgery and chemotherapy, in improving survival outcomes for pediatric patients with malignant ovarian germ cell tumors in low-resource settings.