Work

Primary treatment and survival in malignant ovarian germ cell tumors: A nationwide population-based Swedish Gynecologic Cancer Group (SweGCG) study

Year: 2025

Type: article

Abstract: OBJECTIVE: Although rare, malignant ovarian germ cell tumors (MOGCTs) account for 70 % of ovarian malignancies in women younger than 30 years. Given the rarity of MOGCTs and the limited population-based data, this study aims to examine national treatment patterns and survival in women with MOGCTs, with a focus on fertility-sparing surgery. METHODS: This nationwide population-based study included all women (≥18 years) diagnosed with MOGCTs 2008-2022 in the Swedish Quality Register for Gynecologic Cancer. Main outcome was 5- and 10-year survival. Cox proportional regression models were used in univariable and adjusted survival analyses. RESULTS: The study population included 184 women: 43 with dysgerminomas and 141 with non-dysgerminomas (including 59 immature teratomas, 33 teratomas with malignant transformation, 27 yolk sac tumors, and 22 other subtypes). All but one of the women underwent primary surgery; 54 % had fertility-sparing surgery, and no residual disease was achieved in 89 %. Adjuvant chemotherapy was given to 53 %. During a median follow-up of 5.6 years (range 0.1-15 years), 18 women died. No deaths occurred in women with fertility-sparing surgery. Ten-year relative survival was 95 % (95 % CI 88-103) and overall survival 88 % (95 % CI 82-93). Older age at diagnosis was associated with poorer survival (per year: HR 1.09, 95 % CI 1.05-1.14, p < 0.001), as was FIGO stage IV versus stage I (HR 58, 95 % CI 13-265, p < 0.001). CONCLUSIONS: MOGCTs had excellent survival outcomes in this nationwide population-based study, and fertility-sparing surgery was deemed safe. Future efforts should focus on improving outcomes in older women and those with stage IV disease.

Source: Gynecologic Oncology

DOI: 10.1016/j.ygyno.2025.10.019