Component patterns and survival outcomes in patients with mixed malignant ovarian germ cell tumors: a retrospective cohort study

Objective To evaluate the component patterns and risk stratification in patients with mixed malignant ovarian germ cell tumors (mMOGCT). Methods A retrospective study of 70 mMOGCT patients treated in our hospital between 2000 and 2022 was conducted. The recurrence-free survival (RFS), disease-specific survival (DSS), and risk stratification system based on scoring the identified prognostic factors were assessed. Results Yolk sac tumor component was the most common type (80%), followed by dysgerminoma (50%), immature teratoma (40%), embryonic carcinoma (27.1%), and chorionic carcinoma (15.7%). The 5-year RFS and DSS rates were 77.9% and 87.9%, respectively. FIGO stage III-IV (RR 3.253, P = 0.029) and normalization of tumor markers (TM) ≤ 3 cycles of chemotherapy (RR 6.249, P = 0.017) were risk factors for RFS and DSS, respectively. Significant DSS (RR 8.268, P = 0.006) was also noted between patients who had normalized TM ≤ 4 and ≥ 5 cycles of chemotherapy. FIGO stage I – II and stage III–IV were scored as 0 and 2, respectively. AFP normalization ≤ 3, 4, and ≥ 5 cycles of chemotherapy were scored as 0, 1, and 4, respectively. A total score of 0, 1 – 2, and ≥ 3 were stratified patients into low-risk (43 patients), intermediate-risk (13 patients), and high-risk group (14 patients), respectively. Patients in three risk stratifications manifested significant differences in DSS (P = 0.010) but not RFS (P > 0.05). Conclusion Distinct different component patterns existed among mMOGCT patients, and predicting survival outcomes in a universal model was challenging.