Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 465-470 |
| Number of pages | 6 |
| Journal | Journal of Clinical Oncology |
| Volume | 32 |
| Issue number | 5 |
| DOIs | |
| State | Published - Feb 10 2014 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Surveillance after initial surgery for pediatric and adolescent girls with stage I ovarian germ cell tumors : Report from the children's oncology group. / Billmire, Deborah F.; Cullen, John W.; Rescorla, Frederick J.; Davis, Mary; Schlatter, Marc G.; Olson, Thomas A.; Malogolowkin, Marcio; Pashankar, Farzana; Villaluna, Doojduen; Krailo, Mark; Egler, Rachel A.; Rodriguez-Galindo, Carlos; Frazier, A. Lindsay.
In: Journal of Clinical Oncology, Vol. 32, No. 5, 10.02.2014, p. 465-470.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surveillance after initial surgery for pediatric and adolescent girls with stage I ovarian germ cell tumors
T2 - Report from the children's oncology group
AU - Billmire, Deborah F.
AU - Cullen, John W.
AU - Rescorla, Frederick J.
AU - Davis, Mary
AU - Schlatter, Marc G.
AU - Olson, Thomas A.
AU - Malogolowkin, Marcio
AU - Pashankar, Farzana
AU - Villaluna, Doojduen
AU - Krailo, Mark
AU - Egler, Rachel A.
AU - Rodriguez-Galindo, Carlos
AU - Frazier, A. Lindsay
PY - 2014/2/10
Y1 - 2014/2/10
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84897577103&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897577103&partnerID=8YFLogxK
U2 - 10.1200/JCO.2013.51.1006
DO - 10.1200/JCO.2013.51.1006
M3 - Article
C2 - 24395845
AN - SCOPUS:84897577103
VL - 32
SP - 465
EP - 470
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 5
ER -