Deborah F Billmire1, John W Cullen, Frederick J Rescorla, Mary Davis, Marc G Schlatter, Thomas A Olson, Marcio H Malogolowkin, Farzana Pashankar, Doojduen Villaluna, Mark Krailo, Rachel A Egler, Carlos Rodriguez-Galindo, A Lindsay Frazier. 1. Deborah F. Billmire and Frederick J. Rescorla, Riley Hospital for Children, Indianapolis, IN; John W. Cullen, Rocky Mountain Hospital for Children-Presbyterian St Luke's Medical, Denver, CO; Mary Davis and Marc G. Schlatter, Helen DeVos Children's Hospital at Spectrum Health, Grand Rapids, MI; Thomas A. Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; Marcio H. Malogolowkin, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI; Farzana Pashankar, Yale University, New Haven, CT; Doojduen Villaluna, Children's Oncology Group, Monrovia; Mark Krailo, Keck School of Medicine, University of Southern California, Los Angeles, CA; Rachel A. Egler, Rainbow Babies and Children's Hospital, Cleveland, OH; and Carlos Rodriguez-Galindo and A. Lindsay Frazier, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA.
Abstract
PURPOSE: To determine whether overall survival (OS) can be preserved for patients with stage I pediatric malignant ovarian germ cell tumor (MOGCT) with an initial strategy of surveillance after surgical resection. PATIENTS AND METHODS: Between November 2003 and July 2011, girls age 0 to 16 years with stage I MOGCT were enrolled onto Children's Oncology Group study AGCT0132. Required histology included yolk sac, embryonal carcinoma, or choriocarcinoma. Surveillance included measurement of serum tumor markers and radiologic imaging at defined intervals. In those with residual or recurrent disease, chemotherapy with compressed PEB (cisplatin, etoposide, and bleomycin) was initiated every 3 weeks for three cycles (cisplatin 33 mg/m(2) on days 1 to 3, etoposide 167 mg/m(2) on days 1 to 3, bleomycin 15 U/m(2) on day 1). Survivor functions for event-free survival (EFS) and OS were estimated using the Kaplan-Meier method. RESULTS: Twenty-five girls (median age, 12 years) with stage I MOGCT were enrolled onto AGCT0132. Twenty-three patients had elevated alpha-fetoprotein (AFP) at diagnosis. Predominant histology was yolk sac. After a median follow-up of 42 months, 12 patients had evidence of persistent or recurrent disease (4-year EFS, 52%; 95% CI, 31% to 69%). Median time to recurrence was 2 months. All patients had elevated AFP at recurrence; six had localized disease, two had metastatic disease, and four had tumor marker elevation only. Eleven of 12 patients experiencing relapse received successful salvage chemotherapy (4-year OS, 96%; 95% CI, 74% to 99%). CONCLUSION: Fifty percent of patients with stage I pediatric MOGCT can be spared chemotherapy; treatment for those who experience recurrence preserves OS. Further study is needed to identify the factors that predict recurrence and whether this strategy can be extended successfully to older adolescents and young adults.
PURPOSE: To determine whether overall survival (OS) can be preserved for patients with stage I pediatric malignant ovarian germ cell tumor (MOGCT) with an initial strategy of surveillance after surgical resection. PATIENTS AND METHODS: Between November 2003 and July 2011, girls age 0 to 16 years with stage I MOGCT were enrolled onto Children's Oncology Group study AGCT0132. Required histology included yolk sac, embryonal carcinoma, or choriocarcinoma. Surveillance included measurement of serum tumor markers and radiologic imaging at defined intervals. In those with residual or recurrent disease, chemotherapy with compressed PEB (cisplatin, etoposide, and bleomycin) was initiated every 3 weeks for three cycles (cisplatin 33 mg/m(2) on days 1 to 3, etoposide 167 mg/m(2) on days 1 to 3, bleomycin 15 U/m(2) on day 1). Survivor functions for event-free survival (EFS) and OS were estimated using the Kaplan-Meier method. RESULTS: Twenty-five girls (median age, 12 years) with stage I MOGCT were enrolled onto AGCT0132. Twenty-three patients had elevated alpha-fetoprotein (AFP) at diagnosis. Predominant histology was yolk sac. After a median follow-up of 42 months, 12 patients had evidence of persistent or recurrent disease (4-year EFS, 52%; 95% CI, 31% to 69%). Median time to recurrence was 2 months. All patients had elevated AFP at recurrence; six had localized disease, two had metastatic disease, and four had tumor marker elevation only. Eleven of 12 patients experiencing relapse received successful salvage chemotherapy (4-year OS, 96%; 95% CI, 74% to 99%). CONCLUSION: Fifty percent of patients with stage I pediatric MOGCT can be spared chemotherapy; treatment for those who experience recurrence preserves OS. Further study is needed to identify the factors that predict recurrence and whether this strategy can be extended successfully to older adolescents and young adults.
Authors: G A Hale; N M Marina; D Jones-Wallace; C A Greenwald; J J Jenkins; B N Rao; X Luo; M M Hudson Journal: J Pediatr Hematol Oncol Date: 1999 Mar-Apr Impact factor: 1.289
Authors: P L Mitchell; N Al-Nasiri; R A'Hern; C Fisher; A Horwich; C R Pinkerton; J H Shepherd; C Gallagher; M Slevin; P Harper; R Osborne; J Mansi; T Oliver; M E Gore Journal: Cancer Date: 1999-05-15 Impact factor: 6.860
Authors: Paul C Rogers; Thomas A Olson; John W Cullen; Deborah F Billmire; Neyssa Marina; Frederick Rescorla; Mary M Davis; Wendy B London; Stephen J Lauer; Roger H Giller; Barbara Cushing Journal: J Clin Oncol Date: 2004-09-01 Impact factor: 44.544
Authors: C Kollmannsberger; C Moore; K N Chi; N Murray; S Daneshmand; M Gleave; B Hayes-Lattin; C R Nichols Journal: Ann Oncol Date: 2009-10-29 Impact factor: 32.976
Authors: D Billmire; C Vinocur; F Rescorla; B Cushing; W London; M Schlatter; M Davis; R Giller; S Lauer; T Olson Journal: J Pediatr Surg Date: 2004-03 Impact factor: 2.545
Authors: Adriana Fonseca; Caihong Xia; Armando J Lorenzo; Mark Krailo; Thomas A Olson; Farzana Pashankar; Marcio H Malogolowkin; James F Amatruda; Deborah F Billmire; Carlos Rodriguez-Galindo; A Lindsay Frazier; Furqan Shaikh Journal: J Clin Oncol Date: 2018-12-21 Impact factor: 44.544
Authors: Furqan Shaikh; John W Cullen; Thomas A Olson; Farzana Pashankar; Marcio H Malogolowkin; James F Amatruda; Doojduen Villaluna; Mark Krailo; Deborah F Billmire; Frederick J Rescorla; Rachel A Egler; Bryan J Dicken; Jonathan H Ross; Marc Schlatter; Carlos Rodriguez-Galindo; A Lindsay Frazier Journal: J Clin Oncol Date: 2017-02-27 Impact factor: 44.544
Authors: Bryan J Dicken; Deborah F Billmire; Mark Krailo; Caihong Xia; Furqan Shaikh; John W Cullen; Thomas A Olson; Farzana Pashankar; Marcio H Malogolowkin; James F Amatruda; Frederick J Rescorla; Rachel A Egler; Jonathan H Ross; Carlos Rodriguez-Galindo; A Lindsay Frazier Journal: Pediatr Blood Cancer Date: 2017-12-29 Impact factor: 3.167
Authors: A Lindsay Frazier; Juliet P Hale; Carlos Rodriguez-Galindo; Ha Dang; Thomas Olson; Matthew J Murray; James F Amatruda; Claire Thornton; G Suren Arul; Deborah Billmire; Furqan Shaikh; Farzana Pashankar; Sara Stoneham; Mark Krailo; James C Nicholson Journal: J Clin Oncol Date: 2014-12-01 Impact factor: 44.544
Authors: A F Leary; M Quinn; K Fujiwara; R L Coleman; E Kohn; T Sugiyama; R Glasspool; I Ray-Coquard; N Colombo; M Bacon; A Zeimet; A Westermann; E Gomez-Garcia; D Provencher; S Welch; W Small; D Millan; A Okamoto; G Stuart; K Ochiai Journal: Ann Oncol Date: 2017-04-01 Impact factor: 32.976
Authors: E Kempf; G Desamericq; B Vieites; I Diaz-Padilla; E Calvo; P Estevez; A Garcia-Arreza; M A Martinez-Maestre; I Duran Journal: Clin Transl Oncol Date: 2016-05-18 Impact factor: 3.405
Authors: Thomas A Olson; Matthew J Murray; Carlos Rodriguez-Galindo; James C Nicholson; Deborah F Billmire; Mark D Krailo; Ha M Dang; James F Amatruda; Claire M Thornton; G Suren Arul; Sara J Stoneham; Farzana Pashankar; Daniel Stark; Furqan Shaikh; David M Gershenson; Allan Covens; Jean Hurteau; Sally P Stenning; Darren R Feldman; Peter S Grimison; Robert A Huddart; Christopher Sweeney; Thomas Powles; Luiz Fernando Lopes; Simone dos Santos Agular; Girish Chinnaswamy; Sahar Khaleel; Sherif Abouelnaga; Juliet P Hale; A Lindsay Frazier Journal: J Clin Oncol Date: 2015-08-24 Impact factor: 44.544