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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Surveillance after initial surgery for pediatric and adolescent girls with stage I ovarian germ cell tumors: Report from the children's oncology group
Journal of Clinical Oncology, Volume 32, No. 5, Year 2014
Notification
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Description
Purpose: To determine whether overall survival (OS) can be preserved for patients with stage I pediatric malignant ovarian germ cell tumor (MOGCT) with an initial strategy of surveillance after surgical resection. Patients and Methods: Between November 2003 and July 2011, girls age 0 to 16 years with stage I MOGCT were enrolled onto Children's Oncology Group study AGCT0132. Required histology included yolk sac, embryonal carcinoma, or choriocarcinoma. Surveillance included measurement of serum tumor markers and radiologic imaging at defined intervals. In those with residual or recurrent disease, chemotherapy with compressed PEB (cisplatin, etoposide, and bleomycin) was initiated every 3 weeks for three cycles (cisplatin 33 mg/m2 on days 1 to 3, etoposide 167 mg/m2 on days 1 to 3, bleomycin 15 U/m2 on day 1). Survivor functions for event-free survival (EFS) and OS were estimated using the Kaplan-Meier method. Results: Twenty-five girls (median age, 12 years) with stage I MOGCT were enrolled onto AGCT0132. Twenty-three patients had elevated alpha-fetoprotein (AFP) at diagnosis. Predominant histology was yolk sac. After a median follow-up of 42 months, 12 patients had evidence of persistent or recurrent disease (4-year EFS, 52%; 95% CI, 31% to 69%). Median time to recurrence was 2 months. All patients had elevated AFP at recurrence; six had localized disease, two had metastatic disease, and four had tumor marker elevation only. Eleven of 12 patients experiencing relapse received successful salvage chemotherapy (4-year OS, 96%; 95% CI, 74% to 99%). Conclusion: Fifty percent of patients with stage I pediatric MOGCT can be spared chemotherapy; treatment for those who experience recurrence preserves OS. Further study is needed to identify the factors that predict recurrence and whether this strategy can be extended successfully to older adolescents and young adults. © 2014 by American Society of Clinical Oncology.
Authors & Co-Authors
Billmire, Deborah F.
Unknown Affiliation
Cullen, John W.
Unknown Affiliation
Rescorla, Frederick J.
Unknown Affiliation
Davis, Mary
Unknown Affiliation
Schlatter, Marc G.
Unknown Affiliation
Olson, Thomas A.
Unknown Affiliation
Malogolowkin, Márcio Henrique
Unknown Affiliation
Pashankar, Farzana D.
Unknown Affiliation
Villaluna, Doojduen
Unknown Affiliation
Krailo, Mark D.
Unknown Affiliation
Egler, Rachel A.
Unknown Affiliation
Rodríguez-Galindo, Carlos
Unknown Affiliation
Frazier, Anne Lindsay
Unknown Affiliation
Statistics
Citations: 117
Authors: 13
Affiliations: 11
Identifiers
Doi:
10.1200/JCO.2013.51.1006
ISSN:
0732183X
e-ISSN:
15277755
Research Areas
Cancer
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Participants Gender
Female