Childhood ovarian nonseminomatous germ cell tumors: A highly curable disease with few long-term treatment-related toxicities-Results of the French TGM95 study.
Adolescent
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Biomarkers, Tumor
/ metabolism
Child
Child, Preschool
Chorionic Gonadotropin
/ metabolism
Female
Follow-Up Studies
France
Humans
Neoplasms, Germ Cell and Embryonal
/ metabolism
Ovarian Neoplasms
/ metabolism
Ovariectomy
/ methods
Prognosis
Survival Analysis
Testicular Neoplasms
/ metabolism
alpha-Fetoproteins
/ metabolism
childhood tumor
late effects
nonseminomatous germ cell tumors
ovarian cancer
reproductive issues
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
revised:
11
04
2021
received:
02
12
2020
accepted:
17
05
2021
pubmed:
20
6
2021
medline:
23
11
2021
entrez:
19
6
2021
Statut:
ppublish
Résumé
We report survival and late effects analysis of TGM95 study for childhood (≤18 years) ovarian nonseminomatous germ cell tumors (NS-GCT). Patients with localized tumors (FIGO-stage IA) had no adjuvant treatment (low-risk, LR). Patients with advanced-stage received 3-5 VBP (vinblastin-bleomycin-cisplatin) in intermediate-risk group (IR: FIGO-stage IC-II-III and AFP < 15 000 ng/mL) or 4-6 VIP (etoposide-ifosfamide-cisplatin) in high-risk group (HiR: metastatic or AFP ≥ 15 000 ng/mL). Seventy-seven patients were included (median age = 12 years): 14 LR (13 FIGO-stage IA, 1 retrospectively IC), 26 IR (12 IC, 12 II-III, 2 not-available) and 37 HiR (2 IA with AFP ≥ 15 000 ng/mL, 27 II-III, 8 IV). After a median follow-up of 13.4 years, 12 events (eight relapses) and six deaths (two GCT-related, two due to acute myeloid leukemia and two noncancer related) occurred. All relapses (6 LR, 1 IR) occurred within 2 years. Four contralateral mature teratomas were observed within 8 years. Five-year EFS and OS were 88.2% (95%CI = 79-94%) and 94.6% (95%CI = 87-98%). Seven patients (9%) had bilateral gonadectomy. Among 51 survivors at 2 years aged >15 years (median = 26 years) with remaining ovarian tissue, all had developed spontaneous puberty and 21 (41%) had at least one pregnancy (including two with infertility treatment). Among 69 patients treated with platinum-based chemotherapy, chronic-kidney-disease was diagnosed in four patients (three after VIP) and significant ototoxicity occurred in three (all grade-2). Childhood ovarian NS-GCTs have an excellent prognosis with few late effects. The low-intensive etoposide-free VBP regimen could be an alternative in children with IR disease especially in cases of tumor rupture. The risk of contralateral mature teratoma needs regular monitoring of the remaining ovary.
Substances chimiques
Biomarkers, Tumor
0
Chorionic Gonadotropin
0
alpha-Fetoproteins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1705-1712Informations de copyright
© 2021 UICC.
Références
Akyüz C, Varan A, Büyükpamukçu N, Kutluk T, Büyükpamukçu M. Malignant ovarian tumors in children: 22 years of experience at a single institution. J Pediatr Hematol Oncol. 2000;22(5):422-427.
De Backer A, Madern GC, Oosterhuis JW, et al. Ovarian germ cell tumors in children: a clinical study of 66 patients. Pediatr Blood Cancer. 2006;46(4):459-464.
Zanetta G, Bonazzi C, Cantù M, et al. Survival and reproductive function after treatment of malignant germ cell ovarian tumors. J Clin Oncol. 2001;19(4):1015-1020.
Dark GG, Bower M, Newlands ES, Paradinas F, Rustin GJ. Surveillance policy for stage I ovarian germ cell tumors. J Clin Oncol. 1997;15(2):620-624.
Park JY, Kim DY, Suh DS, et al. Outcomes of pediatric and adolescent girls with malignant ovarian germ cell tumors. Gynecol Oncol. 2015;137(3):418-422.
Clinical Trial AGCT1531. Oncology Group. https://clinicaltrials.gov/show/NCT03067181. Accessed date 20/06/2021.
Williams SD, Birch R, Einhorn LH, Irwin L, Greco FA, Loehrer PJ. Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. N Engl J Med. 1987;316:1435-1440.
Shah R, Xia C, Krailo M, et al. Is carboplatin-based chemotherapy as effective as cisplatin-based chemotherapy in the treatment of advanced-stage dysgerminoma in children, adolescents and young adults? Gynecol Oncol. 2018;150(2):253-260.
Frazier AL, Hale JP, Rodriguez-Galindo C, et al. Revised risk classification for pediatric extracranial germ cell tumors based on 25 years of clinical trial data from the United Kingdom and United States. J Clin Oncol. 2005;33(2):195-201.
Lauritsen L, Kier MG, Bandak M, et al. Pulmonary function in patients with germ cell cancer treated with bleomycin, etoposide, and cisplatin. J Clin Oncol. 2016;34(13):1492-1499.
Cushing B, Giller R, Cullen JW, et al. Randomized comparison of combination chemotherapy with etoposide, bleomycin, and either high-dose or standard-dose cisplatin in children and adolescents with high-risk malignant germ cell tumors: a pediatric intergroup study-Pediatric Oncology Group 9049 and Children's Cancer Group 8882. J Clin Oncol. 2004;22(13):2691-2700.
Solheim O, Tropé CG, Rokkones E, et al. Fertility and gonadal function after adjuvant therapy in women diagnosed with a malignant ovarian germ cell tumor (MOGCT) during the “cisplatin era”. Gynecol Oncol. 2015;136(2):224-229.
Tamauchi S, Kajiyama H, Yoshihara M, et al. Reproductive outcomes of 105 malignant ovarian germ cell tumor survivors: a multicenter study. Am J Obstet Gynecol. 2018;219(4):385.
Dossiers d'information de l'Inserm. Assistance médicale à la procréation (AMP); 2018. https://www.inserm.fr/information-en-sante/dossiers-information/assistance-medicale-procreation-amp. Accessed date 20/06/2021.
Fosså SD, Aass N, Winderen M, Börmer OP, Olsen DR. Long-term renal function after treatment for malignant germ-cell tumours. Ann Oncol. 2002;13:222-228.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296-1305.
Frisina RD, Wheeler HE, Fossa SD, et al. Comprehensive audiometric analysis of hearing impairment and tinnitus after cisplatin-based chemotherapy in survivors of adult-onset cancer. J Clin Oncol. 2016;34(23):2712-2720.
Bokemeyer C, Berger CC, Hartmann JT, et al. Analysis of risk factors for cisplatin-induced ototoxicity in patients with testicular cancer. Br J Cancer. 1998;77:1355-1362.