Retrospective review of 41 patients with endodermal sinus tumor of the ovary.

Forty-one patients with endodermal sinus tumors of the ovary (EST) (23: pure EST, nine: EST with dysgerminoma; and nine: EST with immature teratoma) were treated with cytoreductive surgery, with or without subsequent adjuvant chemotherapy including VAC or PVB. Clinical staging of these patients showed 23 in stage I, six in stage II and 12 in stage III and IV. The outcome was good in the patients with stage I or II disease, with 5- and 10-year survival rates of around 80%. In contrast, all except two patients with stage III or IV disease died within 2 years. Aggressive surgery did not change the outcome of patients with stage I disease. In addition, postoperative chemotherapy was necessary, but the choice of vincristine, actinomycin-D and cyclophosphamide (VAC) or cis-platin, vinblastine and bleomycin (PVB) did not make any difference. Based on the results of the present study, VAC or PVB chemotherapy, after cytoreductive surgery, is essential for cure and conservative surgery followed by VAC or PVB regimen should be recommended for young patients.