Jan 08, 2009
This is perhaps the most encouraging article/study I've read since I started doing my research around Nov 18th..
Journal of Clinical Oncology -
Complete Surgical Excision Is Effective Treatment for Children With Immature Teratomas With or Without Malignant Elements: A Pediatric Oncology Group/Children's Cancer Group Intergroup Study
The study is fairly recent: 1999, and includes the Indiana University Medical Center, which is where my daughter's pathology was conducted, and the hospital is part of that network.
There were 75 "children" (those less than 20 years old) in the study, and 44 of them were ovarian tumors.
The most encouraging part is that the study seemed to indicate a few things:
1) Complete Surgical Staging at the time of excision does not seem essential.
" A comprehensive surgical staging procedure does not seem essential in the treatment of these patients."
2) Some initially mis-diagnosed "Pure Immature Teratomas" were included in the study, and had similar results:
"This study was not designed to treat patients with immature teratoma that contained foci of malignant elements with surgery followed by observation. However, 23 registered patients were treated in this fashion because these histologic features were only recognized on delayed central review. Because more than 6 months had typically elapsed before the discordant review findings and patients seemed to be doing well, it was decided to continue observation and analyze these patients as per initial treatment intention."
Here is a quality finding:
"Only one of the 51 patients with gonadal immature teratomas treated exclusively with surgical resection developed disease recurrence. This patient had an ovarian tumor that contained foci of YST and is currently free of disease after treatment with PEB for recurrence. Thus, the outcome for children with gonadal tumors is excellent, with 98% of patients surviving free of disease in first remission and effective chemotherapy salvage of the one relapsing patient."