Management of malignant dysgerminoma of the ovary
1Department of Gynecology, Competence Center for Ovarian Cancer (EKZE), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, 13353 Berlin, Germany
2Young Academy of Gynecologic Oncology (JAGO) Outreach programme, 13353 Berlin, Germany
3Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, 13353 Berlin, Germany
4Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, 13353 Berlin, Germany
5Experimental and Clinical Research Center (ECRC) of the Charité - Universitätsmedizin Berlin and the Max Delbrueck Center for Molecular Medicine, 13353 Berlin, Germany
6Berliner Institut für Gesundheitsforschung (BIH), 13353 Berlin, Germany
7Department of Pediatric Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, 13353 Berlin, Germany
8Department of Pediatric Hematology and Oncology, University Hospital Bonn, 53113 Bonn, Germany
9Department of Gynecology, Competence Center for Ovarian Cancer (EKZE), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, 13353 Berlin, Germany
DOI: 10.31083/j.ejgo4302041 Vol.43,Issue 2,April 2022 pp.353-362
Submitted: 29 January 2022 Accepted: 09 March 2022
Published: 15 April 2022
The evolution of treatment for malignant ovarian germ cell tumors has been one of the most successful in the history of gynecologic oncology, with dysgerminoma as the most common type of malignant ovarian germ cell tumors. Since the introduction of platinum-based chemotherapy in the 1980s, 5-year survival rates for early-stage dysgerminomas have been close to 100%, and as high as 98% for advanced stages. Despite this remarkable achievement, many questions remain in routine treatment. By performing a literature review, we aim to highlight both the current treatment of malignant dysgerminoma and unanswered questions in the modern management of this disease. These issues relate firstly to surgical therapy, such as the role of routine omentectomy and lymphadenectomy, the value of complete surgical resection, and the possibility of fertility-sparing surgery. Second, chemotherapy and the question of the possibility of de-escalation in early stages and the potential of neoadjuvant chemotherapy in advanced stages will be addressed. Finally, a brief overview of the current developments of new drug treatment regimens will be given.
non epithelial ovarian cancer; ovarian germ cell tumor; dysgerminoma; surgery; chemotherapy; targeted therapies.
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