Role of neoadjuvant chemotherapy in the management of advanced ovarian yolk sac tumor

•This was the first series of applying NACT in OYST with the largest number of advanced patients.•The tumor status and general condition of the patients were improved significantly after NACT.•Patients treated with NACT showed less peri-operative morbidities and better optimal cytoreduction rate, which was the independent prognostic factor.

ObjectiveThe aim of the study was to identify the role of neoadjuvant chemotherapy (NACT) in the treatment of the patients with advanced stage ovarian yolk sac tumor (OYST).MethodsThe comparative study was based on 53 cases with advanced stage OYST registered at Peking Union Medical College Hospital from 1995 to 2010. Twenty one cases were treated with NACT followed by interval debulking surgery (IDS). Thirty two cases were treated with primary debulking surgery (PDS). Data on patient characteristics, treatment and survival were analyzed and compared between two groups to assess the outcome of NACT.ResultsAfter NACT, the overall status of the patients was improved significantly. Patients in NACT had better optimal cytoreduction rate and less peri-operative morbidities. Seven patients (13.2%) suffered from relapse. There was a significantly better PFS for patients with ovarian tumor size > 20 cm in the NACT than those underwent PDS. Residual disease > 2 cm was the independent risk factor of relapse.ConclusionsNACT is the better treatment option for some patients with advanced stage OYST, especially for those with unresectable tumors and poor general condition.