Management of germ cell tumours of the ovary

Abstract

Malignant ovarian germ cell tumours (OGCT) comprise only 2–5% of all ovarian cancers but are significantly different to epithelial ovarian cancers. They affect women of child bearing age and are much more curable than their epithelial counterparts. In addition, the majority of patients will retain their fertility after multimodal treatment. The small numbers of patients mean that randomised controlled trials of chemotherapy, the gold standard test of treatment effectiveness in other malignancies, have proved impossible to perform. The different types of OGCT have variable degrees of chemosensitivity and differing prognoses. Treatment outcomes are also dependent on the stage of disease at diagnosis. In this article, dysgerminomas and non-dysgerminomas are analyzed separately, as there are notable differences in their behaviour and outcomes. It is difficult to think of many diseases in which prognosis has improved as greatly as ovarian germ cell tumours and this is due to modern combination chemotherapy. Like the treatment of testicular cancer, this represents one of the successes of modern medicine.