Cancer: Ovarian yolk sac tumor — Chemotherapy. Treatment
Ovarian yolk sac tumor is a rare and extremely malignant formation, characteristic mainly for girls 6 to 14 years old. The tumor develops from embryonic germ cells and produces alpha-fetoprotein, which serves as its marker. In approximately 5% cases, the disease is bilateral. The main treatment is surgery followed by chemotherapy.
The scope of manipulation depends on the tumor process prevalence and patient’s age. At stage I, the girls and young patients planning the childbirth undergo an organ-preserving intervention. The surgeon makes an abdominal incision through which s/he removes the ovary with the tumor and the adjacent fallopian tube. During surgery, the neighboring organs are scrutinized. The biopsy of the healthy ovary, peritoneum, diaphragm and any suspicious areas is performed. Tissue samples are sent for histological examination.
At a more advanced stage, the resection of the uterus with appendages and greater omentum is indicated. The surgery is performed by laparotomy, which allows a complete examination of the abdominal cavity. The swollen lymph nodes are removed, when required.
In patients with metastases, the cytoreductive intervention is performed to remove the maximum possible number of tumor nodules.
Surgical treatment is contraindicated if the patient is in serious somatic condition, for example, if she has diseases, such as:
- kidney or liver failure,
- severe cardiovascular disease.
A relative contraindication is the appearance of multiple metastases. In such cases, the treatment is initiated with chemotherapy, followed by surgery.
After surgery, all patients receive chemotherapy. Depending on the process stage, platinum drugs are recommended as a monotherapy or in combination with the other cytostatics. The number of courses varies from 3 to 6. The total treatment duration can be up to six months. At the 3rd stage of the disease, subject to a good treatment outcome, a repeated cytoreductive surgery is possible.
After treatment ,the patient should be followed up by the oncologist and undergo examinations, including the physical examination, determination of alpha-fetoprotein level and abdominal ultrasound. In the case of relapse, a second course of anti-tumor agents is recommend.Hide