Objective: To evaluate population-based trends in incidence and survival for women with malignant GCTs (1973-1999). Methods: The SEER database was used to calculate overall and 5-year incidence rates (AAIRs) and survival by age at diagnosis, race, stage, and histology. Frequency distributions were compared using Fishers exact tests, and trends using the Jonckheere-Terpstra lest. Results: A total of 1,119 cases were identified, 1098 (98.1%) ovarian in origin. The overall AAIR was 0.36/100,000 woman-years. By histology, 373 (33.3%) were dysgerminomas, 461 (41.2%) were teratomas (433 immature, 28 mature with malignant degeneration), and 285 (25.5%) were non-dysgerminomas (157 endodermal sinus, 51 embryonal carcinoma, 24 choriocarcinoma, 53 mixed). For dysterminomas, but not other cell types, the AAIRs significantly decreased over calendar time (P = 0.02). By race (white, black, others), others had higher AAIRs (0.32, 0.35, 0.41, P = 0.009). By race, whites and others had higher rates of dysgerminoma compared with blacks (P = 0.01). For localized and distant disease, AAIRs rates decreased by 33.9%, and 23.4%, respectively, but increased for regional disease by 154%, (3.71% /year, P = 0.001). The 5-year relative survival was 82.6%. Survival varied significantly by histology (dysgerminomas 93.2%, teratomas 83.4%, other non-dysgerminomas 68.1%), stage (localized 93.3%, regional 83.7%, distant 66.2%, unstaged 70.0%), and age (0-9 yrs 97.4% vs. 60+ yrs, 22.2%, P < 0.001), but not by race (whites 89.3%, blacks 77.7%, others 82.3%, P = 0.70). Over 27 years, the 5-year survival rates increased by 33%. Conclusions: Malignant GCT AAIRs have decreased for dysgerminomas, and for distant and unstaged disease, and overall survival has also dramatically improved (by 33%). Dysgerminomas have significantly higher survival rates compared to other cell types. Unlike epithelial ovarian cancers, these data indicate that advances in treatment strategies have significantly impacted outcome.
ASJC Scopus subject areas
- Cancer Research