We performed a review of the current modalities of surgical treatment of malignant ovarian
germ cell tumors by clinical stages and histological types. Stage IA
dysgerminoma is performed with a unilateral
salpingo-oophorectomy (USO) without
chemotherapy. However, for Stage IB or IC patients with
dysgerminoma, USO plus
chemotherapy as a primary treatment may or may not be followed with a second-look operation (SLO). For non-
dysgerminomas, USO is indicated only for Stage IA
immature teratoma grade 1. The treatment for Stage IA
immature teratoma grade 2 or 3 and other histological types is USO plus
chemotherapy. Patients with Stage IB, IC or higher with non-
dysgerminoma are treated with USO plus
chemotherapy or USO with contralateral partial
ovariectomy plus
chemotherapy. For patients who require non-conservative surgery, a total abdominal
hysterectomy (TAH) and a bilateral
salpingo-oophorectomy (BSO) plus
chemotherapy are performed. For patients with Stage II of all histological types, conservative surgery consists of USO and a cytoreductive operation plus
chemotherapy, followed by SLO or a second cytoreductive operation. For non-conservative surgery, TAH+BSO with or without a cytoreductive operation plus
chemotherapy is followed by SLO. Conservative surgery for patients with Stage III and IV is USO and a cytoreductive operation plus
chemotherapy followed by a second cytoreductive operation. Non-conservative surgery is TAH+BSO with a cytoreductive operation plus
chemotherapy, followed by SLO or a second cytoreductive operation. However, primary or secondary
cytoreductive surgery with or without
lymphadenectomy and SLO are still controversial in terms of improving patient survival.