[Malignant non-seminomatous germinal tumors of the ovary. Experience of the French Society of Pediatric Oncology. 64 cases].

M C Baranzelli, C Patte, E Bouffet, E Quintana, M Portas, J P Vannier, A Thyss, C Schmitt, F Flamant
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Abstract

Ovary seminomatous malignant germ cell tumours are a particular histopathologica entity. The presence of yolk salk tumor or choriocarcinoma is respectively correlated with elevation of alpha FP or beta hCG. This markers elevation permits to assess diagnosis, appreciate response to treatment, and detect relapses. The study of 64 patients registered in two successive S.F.O.P. protocols (TGM 85-TGM 90) precise indications of surgery, platin-based chemotherapy and results. Malignant non seminomatous germ cell tumors are separated in not secreting pure immature teratoma and secreting malignant germ cell tumours. Surgery is essential for treatment of not secreting pure immature teratoma. Secreting germ cell tumors are very chemosensitive and surgery must be as conservative as possible in all cases even metastatic tumour or relapse. If markers are normalized second-look surgery of secreting malignant germ cell tumours is only necessary in case of evident residual tumour. However in case of initial chemotherapy, resection of a pathological ovary is always performed at the end of treatment. These tumours have a good prognosis: 5-years overall survival and disease-free survival are 85%.

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卵巢恶性非半细胞性生发肿瘤。法国儿科肿瘤学会的经验[64例]。
卵巢半瘤性恶性生殖细胞瘤是一种特殊的组织病理学实体。卵黄瘤或绒毛膜癌的存在分别与α - FP或β - hCG的升高相关。该标志物的升高可用于评估诊断、评价治疗反应和检测复发。该研究对64名连续两种S.F.O.P.方案(TGM 85-TGM 90)注册的患者进行了精确的手术指征,基于铂的化疗和结果。恶性非半瘤性生殖细胞肿瘤分为不分泌纯未成熟畸胎瘤和分泌恶性生殖细胞肿瘤。对于不分泌纯未成熟畸胎瘤的治疗,手术是必不可少的。分泌性生殖细胞肿瘤对化疗非常敏感,手术必须尽可能保守,即使是转移性肿瘤或复发。如果标记物正常,只有在肿瘤残留明显的情况下,才需要进行二次检查。然而,在初始化疗的情况下,病理卵巢切除总是在治疗结束时进行。这些肿瘤预后良好:5年总生存率和无病生存率为85%。
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