J Gynecol Oncol.
2023 Mar;34(2):e12. 10.3802/jgo.2023.34.e12.
Fertility and prognosis assessment between bleomycin/etoposide/cisplatin and paclitaxel/carboplatin chemotherapy regimens in the conservative treatment of malignant ovarian germ cell tumors: a multicenter and retrospective study
- Chu R
1,2 - Liu P1
- Chen J1,2
- Cheng X3
- Li K4
- Che Y5
- Wang J6
- Li L1
- Zhang X1
- Yao S1
- Song L1
- Zhao Y1
- Huang C1
- Xue Y1
- Pan X1
- Li J1
- Chen Z1
- Jiang J1,2
- Kong B1,2
- Song K1,2
- Affiliations
-
- 1Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, P.R. China
- 2Gynecology Oncology Key Laboratory, Qilu Hospital of Shandong University, Jinan, P.R. China
- 3Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R. China
- 4Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
- 5Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
- 6Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, P.R. China
- KMID: 2552512
- DOI: http://doi.org/10.3802/jgo.2023.34.e12
Abstract
Objective
To evaluate the impact of bleomycin/etoposide/cisplatin (BEP) and paclitaxel/carboplatin (PC) chemotherapy regimens on the fertility and prognostic outcomes in malignant ovarian germ cell tumor (MOGCT) patients who underwent fertility-sparing surgery (FSS).
Methods
A propensity score matching algorithm was performed between the BEP and PC groups. The χ2 test and the Kaplan-Meier method were used to compare the fertility outcome, disease-free survival (DFS) and overall survival (OS). The Cox proportional hazards regression analysis was used to identify risk factor of DFS.
Results
We included 213 patients, 185 (86.9%) underwent BEP chemotherapy, and 28 (13.1%) underwent PC chemotherapy. The median age was 22 years (range, 8–44 years), and the median follow-up period was 63 months (range, 2–191 months). Fifty-one (29.3%) patients had a pregnancy plan, and 35 (85.4%) delivered successfully. In the before and after propensity score matching cohorts, there were no significant differences in spontaneous abortion, selective termination of pregnancy, during-pregnancy status, and live birth between the BEP and PC groups (p>0.05). Fourteen (6.6%) patients experienced recurrence, including 11 (5.9%) in the BEP group and 3 (10.7%) in the PC group. Four (1.9%) patients in the BEP group died. Kaplan-Meier analysis revealed no significant differences in DFS (p=0.328) and OS (p=0.446) between the BEP and PC groups, and the same survival results were observed in the after matching cohort.
Conclusion
The PC regimen is as safe as the BEP regimen for MOGCT patients with fertility preservation treatment, and no differences were observed in fertility and clinical prognosis.
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