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Surgery and chemotherapy (stages II–IV)
Source: Childhood Extracranial Germ Cell Tumors Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: November 5, 2024 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.
While advanced-stage ovarian dysgerminomas, like testicular seminomas, are highly curable with surgery and radiation therapy, the effects on growth, fertility, and risk of treatment-induced second malignancy in these young patients [25,26] make chemotherapy a more attractive adjunct to surgery.[27,28] Complete tumor resection is the goal for advanced dysgerminomas. Platinum-based chemotherapy can be given preoperatively to facilitate resection or postoperatively (after debulking surgery) to avoid mutilating surgical procedures.[23]
Evidence (surgery and chemotherapy for stage II–IV dysgerminomas):
In a report from the French Society of Pediatric Oncology, 48 girls younger than 19 years (median age, 12.8 years) were registered; 20 patients had localized disease, 28 patients had locoregional disease, and no patients had metastases. Seven patients had positive para-aortic lymph nodes. Forty-seven patients underwent primary surgery. Before 1998, all patients with advanced disease received radiation therapy. After a practice change in 1998, patients were treated with platinum-based chemotherapy.[24][Level of evidence C1]
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In a report from the French Society of Pediatric Oncology, 48 girls younger than 19 years (median age, 12.8 years) were registered; 20 patients had localized disease, 28 patients had locoregional disease, and no patients had metastases. Seven patients had positive para-aortic lymph nodes. Forty-seven patients underwent primary surgery. Before 1998, all patients with advanced disease received radiation therapy. After a practice change in 1998, patients were treated with platinum-based chemotherapy.[24][Level of evidence C1]
The 5-year EFS rate was 91%, and the 5-year OS rate was 100%.
In a report from the French Society of Pediatric Oncology, 48 girls younger than 19 years (median age, 12.8 years) were registered; 20 patients had localized disease, 28 patients had locoregional disease, and no patients had metastases. Seven patients had positive para-aortic lymph nodes. Forty-seven patients underwent primary surgery. Before 1998, all patients with advanced disease received radiation therapy. After a practice change in 1998, patients were treated with platinum-based chemotherapy.[24][Level of evidence C1]
Side effects were not severe, and several patients became pregnant in later years.
A meta-analysis of patients with dysgerminoma by the Malignant Germ Cell Tumor International Consortium reported the following:[29]
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A meta-analysis of patients with dysgerminoma by the Malignant Germ Cell Tumor International Consortium reported the following:[29]
No difference was seen between patients who were treated with cisplatin (n = 70) (5-year EFS rate, 93%; OS rate, 96%) and patients who were treated with carboplatin (n = 56) (5-year EFS rate, 96%; OS rate, 96%).
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Preserved source evidence · Not medical advice