Chemotherapy for adult women diagnosed with a rare type of ovarian cancer of all stages (malignant germ cell cancer of the ovary)

Malignant germ cell cancer of the ovary (type of ovarian cancer) is a very rare type of cancer. Malignant ovarian germ cell cancer is a term used to describe a group of heterogeneous rare tumours affecting the ovaries. These tumours start in the egg (ovum) producing cells of the ovary, whereas the more common epithelial ovarian cancers start in the cells that cover the surface of the ovary. Unlike epithelial ovarian cancers, these tumours are often diagnosed early and a combination of surgery and chemotherapy usually results in favourable long term overall survival. Due to its rarity, this review is based on only one very small RCT and one small retrospective study. The data from these studies were too sparse to adequately assess the effectiveness and safety of chemotherapy after surgery (adjuvant chemotherapy) in the treatment of malignant germ cell ovarian cancer. All comparisons were restricted to single study analyses and this review was only based on 32 women, so it was not adequately powered to detect differences in survival. Adverse effects of treatment and recurrence-free survival were incompletely documented and QoL was not reported in any of the studies. We did not find any studies that reported specifically on adults as this disease usually afflicts younger people as opposed to the older population, so there were problems in separating data on adults and children in many of the studies. Many of the treatments used were taken from experiences of treating patients with testicular cancer, as they look similar under the microscope and behave similar clinically. Due to the small number of patients with malignant germ cell cancer in the two studies, our review shows that there were no good quality studies assessing the role of chemotherapy in this disease, be it in early or late stages. There was insufficient evidence to conclude that any form of chemotherapy or best supportive care is superior over the other. This review highlights the need for future good quality, well designed studies.