Therapy of advanced XXXX .

@entity43 @entity1 @entity66 @entity722 @entity5 @entity2971 @entity843 @entity900 @entity1442 @entity4097
BACKGROUND: Gonadal sex @entity4097 are rare @entity5 that develop from the gonadal non-germ cell component such as granulosa, Sertoli or Leydig cells. Among these, juvenile @entity722 (JGCT) constitute the largest subgroup of @entity43 during childhood and adolescence. In @entity66 (FIGO stage I), the beneficial role of @entity5 is well established. In contrast, life expectancy in @entity1 with advanced JGCT (FIGO stage >/= II) is short even after complete @entity5 resection. The current literature provides only limited and inconclusive data regarding the value of adjuvant chemotherapy in such @entity1 with @entity1442 . @entity1 AND METHODS: Therefore, we analyzed the @entity1 with FIGO stage >/= II JGCT who were prospectively documented as follow-up @entity1 of the German MAKEI trials for non-testicular germ cell @entity5 and received the recommended @entity900 -based chemotherapy in an adjuvant setting. From 1988 until 2000, 7 @entity1 (age, 4;2 - 18;11 years, median 14;8 years) were registered. Three @entity1 were stage IIc, one stage IIIa, and three stage IIIc. 5 @entity1 underwent laparatomy with adnectomy, which was complete in only two @entity1 . Two @entity1 received laparoscopic @entity5 resection, which was incomplete in both. All @entity1 received 4 or 6 cycles of adjuvant @entity900 -based three-agent chemotherapy in analogy to the current therapeutic concept applied in @entity2971 . One @entity1 with a large @entity5 and multiple peritoneal metastases additionally received 40 Gy abdominal irradiation. RESULTS: All @entity1 achieved complete clinical remission after initial surgery and adjuvant chemotherapy. 4 out of 7 @entity1 are currently remaining in first continuous complete remission after 15 to 111 months follow-up. One @entity1 developed a @entity5 of the contralateral ovary after 126 months follow-up and is still alive but currently in therapy of another recurrence. Another @entity1 suffered a @entity5 recurrence after 12 months but achieved a second complete remission with @entity900 chemotherapy after a follow-up of currently 4 months. One @entity1 achieved complete clinical remission but suffered a diffuse peritoneal @entity5 recurrence with massive @entity843 and finally died as a result of @entity5 progression. In summary, at the time of this report 6 of 7 @entity1 are alive after a median of 47 (15 - 138) months. CONCLUSION: This analysis clearly demonstrates that advanced JGCT can be successfully treated with surgery followed by adjuvant @entity900 -based chemotherapy. Therefore, this study reveals encouraging therapeutic perspectives in these otherwise fatal @entity5 that merit further investigation in a prospective cooperative trial.
