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Ovarian germ cell tumors derive from ovarian germ cells and account for approximately 20% of all ovarian neoplasms. Only 1–2% of ovarian germ cell tumors are called malignant ovarian germ cell tumors and constitute approximately 3–5% of all malignant ovarian neoplasms.[1][1] Yolk sac tumor

ObjectiveThe aim of this study was to evaluate the clinicopathologic characteristics of patients with ovarian yolk sac tumor and the benefit of omentectomy in patients with clinical early-stage disease.MethodsThe medical records of 66 patients with ovarian yolk sac tumor were reviewed retrospectively.ResultsThere were 37, 8, 14, and 7 patients with stages I, II, III, and IV disease, respectively. Sixty-five patients received surgery and adjuvant chemotherapy, and 1 had chemotherapy only. The median follow-up was 78 months. The overall 5-year survival rate was 86.0%. Univariate analysis revealed that stage (P = 0 .022), age (P = 0.001), residual tumor (P = 0.036), and satisfactory α-fetoprotein (AFP) decline (defined as normalization of AFP after the first or second cycles of postsurgery chemotherapy, P = 0.006) were significant prognostic factors. Multivariate analysis revealed that satisfactory AFP decline was an independent significant prognostic factor for overall survival (P = 0.028). The postoperative pathology showed that only 1 (2.7%) of 37 patients who received omentectomy without gross spread had omentum metastasis microscopically. The 5-year survival rates were 89.2% and 100.0% for stage I-II patients with (36 cases) or without (9 cases) omentectomy, respectively (P > 0.05). Three of the 7 patients with recurrence were successfully salvaged and lived 38.0, 102.6, and 45.2 months after initial diagnosis.ConclusionsPostsurgery satisfactory AFP decline was an independent significant prognostic factor for patient survival. Omentectomy might not be of therapeutic significance for clinical stage I-II patients.

Chen R-J, Huang S-C, Chow S-N, Hsieh C-Y, Lin M-C, Hsu H-C. Influence of chemotherapy or liver metastasis on the immunoelectrophoretic discrimination of alpha-fetoprotein from yolk sac tumor. Int J Gynecol Cancer 1997;7: 486– 489. The main purpose of this study was to determine whether chemotherapy or liver metastasis can interfere with the discrimination of yolk sac tumor alpha-fetoprotein (AFP) from that of hepatocellular carcinoma. The AFP pattern in six cases of yolk sac tumor with or without liver metastasis was studied both during and after chemotherapy using affinity immunoelectrophoresis. Six cases of hepatocellular carcinoma which werematched by AFP level with yolk sac tumors were used for comparison. The pattern produced by yolk sac tumor consists of a prominent L2 band and a light L3 band. Hepatocellular carcinoma produced a prominent L1 band and a light L3 band. The presence or absence of liver metastasis did not affect the pattern from ovarian yolk sac tumor, nor did chemotherapy interfere with the ability to discriminate between patterns. Our findings indicate that, using affinity immunoelectrophoresis, we are able to discriminate yolk sac tumor with or without liver metastasis from hepatocellular carcinoma. This discrimination is not affected by the administration of chemotherapy.