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79

NCCN Guidelines for Patients

®

:

Ovarian Cancer, Version 1.2017

6

Treatment guide

Malignant germ cell tumors

Guide 26. Possible response to chemotherapy for malignant germ cell tumors

Disease status Follow-up care Treatment options

Complete clinical response

ª

Observe

• If abnormal markers

with definitive

recurrent disease

ª

• Consider chemotherapy

or

• High-dose chemotherapy

Residual tumor on imaging

with normal tumor markers

ª

Consider surgery or

observe

• If necrotic tissue

ª

• Observe

Consider surgery or

observe

• If benign teratoma

ª

• CT of the chest, abdomen, and

pelvis or MRI as needed

Consider surgery or

observe

• If residual malignancy

ª

• Consider more platinum-based

chemotherapy for 2 cycles

Elevated tumor markers

(persistent) with definitive

residual disease

ª

• TIP (paclitaxel + ifosfamide + cisplatin)

or

• High-dose chemotherapy (strong

recommendation for care at a major

hospital for possible stem-cell transplant

and curative therapy)

Guide 26

shares the response to chemotherapy for

germ cell tumors. A complete response is followed by

observation and possible chemotherapy if disease

comes back (recurs). If residual tumor remains and

tumor markers are normal, surgery or observation is

considered. If more information is needed after a

benign (no cancer) teratoma is found, tests can be

ordered, and you may be observed. If necrotic (dead)

tissue is found, you may also be observed.