Background: Malignant ovarian germ cell tumors (MOGCTs) account for approximately 2–5% of malignant ovarian tumors. The objectives of this study were to evaluate the survival and reproductive outcomes of MOGCTs after treatment at any stage. 

Methods: The current retrospective study showed a total of 110 patients with MOGCTs who were treated at the National Institute of Cancer and Research Hospital (NICRH), Dhaka, Bangladesh, from 2014 to 2022. A total of 33 patients had lost follow-up and 77 patients had completed the routine follow-up, enrolled in this study.

Results: The median age of these patients was 23 years (range: 9–66 years). The median follow-up time was 5.55 years (range 1.5–10 years). Disease-free survival (DFS) and overall survival (OS) were at 5 years, 93.5% and 90.3%, respectively and at 10 years, 90.3% and 96.7% respectively. DFS was higher (5.76±2.25) in the operable stage than in the inoperable stage (4.91±2.52), found statistically significant (p=0.001). DFS were complete surgical staging, incomplete surgical staging, and fertility sparing surgery (4.45±2.29, 5.08±2.90, and 5.31±3.37 years, respectively). According to FIGO stages I, II, III and IV were 5.61±61, 4.00±00, 3.64±2.16 and 0.50±00 years, respectively. According to histopathological type: yolk sac tumor, dysgerminoma, immature teratoma, and mixed germ cell tumor were 5.21±2.92. 5.35±3.50, 4.78±2.91 and 3.60±2.48 years, respectively. The univariate analysis showed DFS were higher in operable stage (5.75±2.25), fertility sparing surgery (5.31±3.37), FIGO stage I (5.61±3.37), dysgerminoma (5.21±2.92), and grade I (4.38±2.58), but operable stage was statistically significant (p=0.001). The multivariate analysis showed FIGO stage were found to be independently significant predictors for DFS, HR 3.25 (p =.010). A total of 9.7% had persistent disease, and 9.7% had recurrence. Their mortality rate was 8.9% due to their disease. Reproductive outcome: the menstrual cycle resumes at 42.3%, and the regular cycle was at 57.7%. Only 35.5% of patients were trying to conceived. Among them, 28.9% were conceived. Outcome of pregnancy: 0% abortions, 9.6% preterm birth, 19.3% term pregnancy. All children's development was normal (up to 2 years) except for one reported congenital anomaly.

Conclusion: MOGCTs can achieve a good prognosis after surgery and chemotherapy. This study suggests that FSS is a safe treatment option for MOGCTs, regardless of tumor stage and histopathological type.

Will be updated soon