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
- Author:
Ran CHU
1
;
Penglin LIU
;
Jingying CHEN
;
Xiaodong CHENG
;
Kezhen LI
;
Yanci CHE
;
Jianliu WANG
;
Li LI
;
Xi ZHANG
;
Shu YAO
;
Li SONG
;
Ying ZHAO
;
Changzhen HUANG
;
Ying XUE
;
Xiyu PAN
;
Junting LI
;
Zhongshao CHEN
;
Jie JIANG
;
Beihua KONG
;
Kun SONG
Author Information
- Publication Type:Original Article
- From:Journal of Gynecologic Oncology 2023;34(2):e12-
- CountryRepublic of Korea
- Language:English
-
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.
