Different Managements of the same disease- Malignant Ovarian Germ Cell Tumor Treated by Pediatric or Gynecologic Oncologists

Objective: The surgical approach, staging system, including the criteria for adjuvant chemotherapy and even the chemotherapeutic regimens between Pediatric and Gynecologic oncologists are different for a same disease- malignant ovarian germ cell tumors (MOGCTs). This study is to review the differences with regard to the survival and re-appraise each mode of treatment. Methods: A retrospective review of medical records of the patients with malignant germ cell tumor in Mackay Memorial Hospital between 1997 ~ 2017 were performed. We re-staged the patients in pediatric group from COG stage system to FIGO stage system and documented the disease survival rate in different staging system. Accordingly, treatment outcomes were compared by progression-free survival rate, using Kaplan-Meier method. Results: 87 patients with MOGCTs were analyzed. 67 cases are managed by Gynecologist and 20 cases by Pediatrician. There was no significant differences of the progression-free survival rate at 10 years in patients with conservative surgery or fertility-sparing staging operation (p = 0.747). Ten-year progression free survival rate in patient receiving chemotherapy with BEP regimen (bleomycin + etoposide + cisplatin) was 97.8% and in JEB regimen (bleomycin + etoposide + carboplatin) was 77.8% (p = 0.0076). Conclusion: The survival rates are similar between patients receiving conservative surgical approach or complete staging operation. It might be due to the high chemosensitivity nature of these diseases. However, our data suggest cisplatin is more effective than carboplatin in high-risk group.