TY - JOUR
T1 - Administration of standard-dose BEP regimen (bleomycin + etoposide + cisplatin) is essential for treatment of ovarian yolk sac tumour
AU - Satoh, Toyomi
AU - Aoki, Yoichi
AU - Kasamatsu, Takahiro
AU - Ochiai, Kazunori
AU - Takano, Masashi
AU - Watanabe, Yoh
AU - Kikkawa, Fumitaka
AU - Takeshima, Nobuhiro
AU - Hatae, Masayuki
AU - Yokota, Harushige
AU - Saito, Toshiaki
AU - Yaegashi, Nobuo
AU - Kobayashi, Hiroaki
AU - Baba, Tsukasa
AU - Kodama, Shoji
AU - Saito, Tsuyoshi
AU - Sakuragi, Noriaki
AU - Sumi, Toshiyuki
AU - Kamura, Toshiharu
AU - Yoshikawa, Hiroyuki
N1 - Funding Information:
This study was supported in part by the National Cancer Center Research and Development Fund (Nos. 23-A-17 and 26-A-4 ) and the Grants-in-Aid for Cancer Research (Nos. 18-06 and 10103749 ) from the Ministry of Health, Labor, and Welfare of Japan .
Publisher Copyright:
© 2014 Elsevier Ltd. All rights reserved.
PY - 2015/2
Y1 - 2015/2
N2 - Aim The aim of this study was to investigate prognostic factors, including postoperative chemotherapy regimen, for the treatment of ovarian yolk sac tumour (YST), and resulting fertility outcome. Methods A multi-institutional retrospective investigation was undertaken to identify patients with ovarian pure or mixed YST who were treated between 1980 and 2007. Postoperative chemotherapy regimen and other variables were assessed in univariate and multivariate analyses. Additionally, the reproductive safety of the BEP (bleomycin, etoposide and cisplatin) regimen was evaluated. Results There were 211 patients enrolled from 43 institutions. The BEP regimen and a non-BEP regimen were administered to 112 and 99 patients as postoperative chemotherapy, respectively. In univariate and multivariate analyses, age ≥ 22, alpha-fetoprotein ≥ 33,000 ng/ml, residual tumours after surgery and non-BEP regimen were independently and significantly associated with poor overall survival (OS). BEP was significantly superior to non-BEP in 5-year OS (93.6% versus 74.6%, P = 0.0004). Reduced-dose BEP (<75% standard-dose bleomycin and < 50% etoposide dose) was significantly associated with poorer 5-year OS compared with standard-dose BEP (89.4% versus 100%, P = 0.02 and 62.5% versus 96.9%, P = 0.0002). All patients who underwent fertility-sparing surgery recovered their menstrual cycles. Sixteen of 23 patients receiving BEP (70.0%) and 13 of 17 patients receiving non-BEP (76.5%) who were nulliparous at fertility-sparing surgery and married at the time of investigation gave birth to 21 and 19 healthy children, respectively. Conclusions The results of the present study suggest that standard-dose BEP should be administered for ovarian YST. BEP is as safe as non-BEP for preserving reproductive function.
AB - Aim The aim of this study was to investigate prognostic factors, including postoperative chemotherapy regimen, for the treatment of ovarian yolk sac tumour (YST), and resulting fertility outcome. Methods A multi-institutional retrospective investigation was undertaken to identify patients with ovarian pure or mixed YST who were treated between 1980 and 2007. Postoperative chemotherapy regimen and other variables were assessed in univariate and multivariate analyses. Additionally, the reproductive safety of the BEP (bleomycin, etoposide and cisplatin) regimen was evaluated. Results There were 211 patients enrolled from 43 institutions. The BEP regimen and a non-BEP regimen were administered to 112 and 99 patients as postoperative chemotherapy, respectively. In univariate and multivariate analyses, age ≥ 22, alpha-fetoprotein ≥ 33,000 ng/ml, residual tumours after surgery and non-BEP regimen were independently and significantly associated with poor overall survival (OS). BEP was significantly superior to non-BEP in 5-year OS (93.6% versus 74.6%, P = 0.0004). Reduced-dose BEP (<75% standard-dose bleomycin and < 50% etoposide dose) was significantly associated with poorer 5-year OS compared with standard-dose BEP (89.4% versus 100%, P = 0.02 and 62.5% versus 96.9%, P = 0.0002). All patients who underwent fertility-sparing surgery recovered their menstrual cycles. Sixteen of 23 patients receiving BEP (70.0%) and 13 of 17 patients receiving non-BEP (76.5%) who were nulliparous at fertility-sparing surgery and married at the time of investigation gave birth to 21 and 19 healthy children, respectively. Conclusions The results of the present study suggest that standard-dose BEP should be administered for ovarian YST. BEP is as safe as non-BEP for preserving reproductive function.
KW - BEP regimen
KW - Fertility
KW - Ovarian yolk sac tumour
KW - Prognosis
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U2 - 10.1016/j.ejca.2014.12.004
DO - 10.1016/j.ejca.2014.12.004
M3 - Article
C2 - 25559616
AN - SCOPUS:84922625798
VL - 51
SP - 340
EP - 351
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 3
ER -