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

Sköld, Camilla ; Rådestad, Angelique Flöter ; Bohlin, Katja Stenström ; Bjurberg, Maria LU ; Borgfeldt, Christer LU ; Hellman, Kristina ; Jönsson, Jenny Maria LU ; Kjølhede, Preben ; Lundqvist, Elisabeth Åvall and Olsson, Cecilia , et al. (2025) In Gynecologic Oncology 203. p.59-66
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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dysgerminoma, Germ cell tumors, Non-dysgerminoma, Non-epithelial, Population-based
in
Gynecologic Oncology
volume
203
pages
8 pages
publisher
Academic Press
external identifiers
  • pmid:41166982
  • scopus:105020306660
ISSN
0090-8258
DOI
10.1016/j.ygyno.2025.10.019
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Authors
id
905b677b-91a8-4218-9679-2dffacc9abf5
date added to LUP
2025-12-10 09:46:33
date last changed
2025-12-10 09:48:30
@article{905b677b-91a8-4218-9679-2dffacc9abf5,
  abstract     = {{<p>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 &lt; 0.001), as was FIGO stage IV versus stage I (HR 58, 95 % CI 13–265, p &lt; 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.</p>}},
  author       = {{Sköld, Camilla and Rådestad, Angelique Flöter and Bohlin, Katja Stenström and Bjurberg, Maria and Borgfeldt, Christer and Hellman, Kristina and Jönsson, Jenny Maria and Kjølhede, Preben and Lundqvist, Elisabeth Åvall and Olsson, Cecilia and Stålberg, Karin and Holmberg, Erik and Kähler, Pernilla Dahm}},
  issn         = {{0090-8258}},
  keywords     = {{Dysgerminoma; Germ cell tumors; Non-dysgerminoma; Non-epithelial; Population-based}},
  language     = {{eng}},
  pages        = {{59--66}},
  publisher    = {{Academic Press}},
  series       = {{Gynecologic Oncology}},
  title        = {{Primary treatment and survival in malignant ovarian germ cell tumors : A nationwide population-based Swedish Gynecologic Cancer Group (SweGCG) study}},
  url          = {{http://dx.doi.org/10.1016/j.ygyno.2025.10.019}},
  doi          = {{10.1016/j.ygyno.2025.10.019}},
  volume       = {{203}},
  year         = {{2025}},
}