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Background <p>Vaginal malignant germ cell tumors (MGCTs), predominantly yolk sac tumors, are extremely rare, with no established consensus on optimal management. This study evaluated whether post-chemotherapy surgery is necessary for vaginal MGCTs.</p> Methods <p>A retrospective analysis was conducted on patients diagnosed with vaginal MGCTs from 1996 to 2023. Progression-free survival (PFS), overall survival (OS), the impact of surgical intervention, and the presence of post-chemotherapy residual mass (RM) were assessed.</p> Results <p>Seventy-five patients (median age:11 months) were included. Six underwent initial tumor resection, and all received platinum-based chemotherapy. RM was detected post-chemotherapy in 57% of evaluable cases (40/70), with vaginoscopy outperforming standard imaging in detection (<i>p</i> &lt; 0.001). The 5-year PFS and OS rates were 83% (95%CI: 71–90) and 94% (95%CI: 84–98), respectively. Neither RM (<i>p</i> = 0.64) nor delayed surgical intervention (5-year PFS: 77% (95%CI: 54–90) without surgery <i>versus</i> 85% (95%CI: 70–92) with surgery; log-rank test <i>p</i> = 0.72) significantly impacted PFS.</p> Discussion <p>Neoadjuvant platinum-based chemotherapy yields excellent survival outcomes in vaginal MGCTs. Vaginoscopy appears more sensitive than standard imaging for RM detection and is recommended for post-chemotherapy evaluation. In the absence of RM on vaginoscopy and with negative tumor markers, systematic post-chemotherapy surgery may be unnecessary. A global consensual framework for managing is proposed.</p>

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Vaginal germ cell tumors: results from the international retrospective VAGIPED study

  • 期刊论文

  • 发表日期：

    2025年9月24日

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  • Cécile Faure-Conter,
  • Luiz Fernando Lopes,
  • Yijin Gao,
  • Gabriele Calaminus,
  • Monica Terenziani,
  • Maria Debora De Pasquale,
  • Agnes Vojcek,
  • Orjana Velikonja,
  • Joanna Stefanowicz,
  • Shayi Jiang,
  • Xiaojun Yuan,
  • Yali Han,
  • Ricardo López-Almaraz,
  • Anthony Penn,
  • Claire Stokes,
  • Michelle Nuno,
  • Lindsay Frazier,
  • Deborah F. Billmire,
  • Brice Fresneau,
  • Claire Cropet

摘要

Background

Vaginal malignant germ cell tumors (MGCTs), predominantly yolk sac tumors, are extremely rare, with no established consensus on optimal management. This study evaluated whether post-chemotherapy surgery is necessary for vaginal MGCTs.

Methods

A retrospective analysis was conducted on patients diagnosed with vaginal MGCTs from 1996 to 2023. Progression-free survival (PFS), overall survival (OS), the impact of surgical intervention, and the presence of post-chemotherapy residual mass (RM) were assessed.

Results

Seventy-five patients (median age:11 months) were included. Six underwent initial tumor resection, and all received platinum-based chemotherapy. RM was detected post-chemotherapy in 57% of evaluable cases (40/70), with vaginoscopy outperforming standard imaging in detection (p < 0.001). The 5-year PFS and OS rates were 83% (95%CI: 71–90) and 94% (95%CI: 84–98), respectively. Neither RM (p = 0.64) nor delayed surgical intervention (5-year PFS: 77% (95%CI: 54–90) without surgery versus 85% (95%CI: 70–92) with surgery; log-rank test p = 0.72) significantly impacted PFS.

Discussion

Neoadjuvant platinum-based chemotherapy yields excellent survival outcomes in vaginal MGCTs. Vaginoscopy appears more sensitive than standard imaging for RM detection and is recommended for post-chemotherapy evaluation. In the absence of RM on vaginoscopy and with negative tumor markers, systematic post-chemotherapy surgery may be unnecessary. A global consensual framework for managing is proposed.