Figure 1(A).
Figure 1(B).
Figure 2(A).
Figure 2(B).
Figure 3(A).
Figure 3(B).
Figure 4(A).
Figure 4(B).
Patient’s demographic and clinical characteristics_
| Characteristics | n = 116 |
|---|---|
| Median follow up | 40 (5–72 months) |
| Median age at diagnosis | 13.5 years (10–17) |
| ≤11 years | 20 (17.24%) |
| >11 years | 94 (81.0%) |
| Histology | |
| Dysgerminoma | 45 (38.7%) |
| Embryonal carcinoma | 5 (4.3%) |
| Yolk Sac Tumour | 34 (29.3%) |
| Mixed Germ Cell Tumour | 32 (27.6%) |
| Stage | |
| I | 13 (11.2%) |
| II | 10 (8.6%) |
| III | 56 (48.3%) |
| IV | 37 (31.9%) |
| AFP (Alpha feto protein) | |
| <10 | 43 (37.1%) |
| 10–100 | 10 (8.6%) |
| 100–1000 | 14 (12.1%) |
| >1000 | 49 (42.2%) |
| Surgery | |
| Upfront surgery only | 102 (87.9%), |
| Delayed surgery + salvage surgery | 22 (12.1%) |
| Risk group | |
| Low | 16 (13.8%) |
| Intermediate | 43 (37.1%) |
| High | 57 (49.1%) |
| First-line chemotherapy | |
| JEB (Carboplatin, etoposide, bleomycin) | 75 (64.7%) |
| BEP (bleomycin, etoposide, cisplatin) | 29 (25.0%) |
| PEB (cisplatin, Etoposide, Bleomycin) | 5 (4.3%) |
| No chemotherapy | 7 (6.03%) |
Stage and Risk Stratification_
| Stage | Features |
|---|---|
| I | Limited to the ovary (peritoneal evaluation should be negative). There is no evidence of disease beyond the ovaries. (Note: The presence of gliomatosis peritonei does not result in changing Stage I disease to a higher stage.) |
| II | Microscopic residual; peritoneal evaluation negative. (Note: The gliomatosis peritonei does not change Stage II disease to a higher stage. Tumor markers normalize or decrease with an appropriate half-life. |
| III | Lymph node involvement (metastatic nodule); gross residual or biopsy only; contiguous visceral involvement (omentum, intestine, bladder); peritoneal evaluation positive for malignancy. |
| IV | Distant metastases, including the liver. |
Characteristics of patients with deaths (n=11)_
| Number | Age at Diagnosis (Years) | Histology | Stage | Surgery | Adjuvant Chemotherapy | Time from Diagnosis to progression, relapse (months) | Treatment after Progression or Recurrence | Status |
|---|---|---|---|---|---|---|---|---|
| 1 | 15 | YST | 3(HR) | Laparotomy | BEP (6 cycles) | 5months (progression) | Gemcitabine/oxaliplatin (6 cycles) | Died (due to progression) |
| 2 | 11 | YST | 3(HR) | Mets in liver | JEB (6 cycles) | 7 months (progression) | VeIP (6 cycle) | Died (due to progression) |
| 3 | 13 | Mixed GCT | 4(HR) | Nil | JEB (6 cycles) | 5 months (progression) | VeIP (6 cycles) | Died (due to progression) |
| Gemcitabine/oxaliplatin (6 cycles) | ||||||||
| 4 | 11 | Mixed GCT | 4(HR) | Laparotomy | BEP (4 cycles) | 36 months (relapse) | TIP (4 cycles) | Died (due to progression) |
| 5 | 12 | Dysgerminoma | 4(HR) | Nil | BEP (2 cycles) | 5 months (progression) | VeIP (2 cycle) | Died (due to progression) |
| 6 | 11 | YST | 4(HR) | Nil | JEB (6 cycles) | 14 months (progression) | VeIP (3 cycles) | Died (due to progression) |
| Gemcitabine/vinorelbine (1 cycle) | ||||||||
| 7 | 16 | Mixed GCT | 4(HR) | Nil | JEB (3 cycles) | 1 months (progression) | BEP (1 cycle) | Died (due to toxicity) |
| 8 | 17 | YST | 3(HR) | Irresectable | BEP (6 cycles) | 24 months (progression) | VeIP(1 cycle) | Died (due to toxicity) |
| VIP(1cycle) | ||||||||
| 9 | 11 | YST | 4(HR) | Nil | JEB (1 cycles) | 5 months (progression) | Nil | Died (due to toxicity) |
| 10 | 15 | Mixed GCT | 4(HR) | Nil | JEB (1 cycles) | 14 months (progression) | Nil | Died (due to toxicity) |
| 11 | 11 | Dysgerminoma | 4(HR) | Nil | JEB (6 cycles) | 36 months (Secondary AML) | Nil | Died (due to secondary AML) |