Objective      To analyze the clinical characteristics and treatment outcome of children with malignant ovarian germ cell tumor

and to investigate the therapeutic strategy.       Methods      Clinical manifestations

treatment outcome and follow-up data of 62 children with malignant ovarian germ cell tumor in our department from Jan. 2001 to Dec. 2009 were analyzed.       Results       Abdominal pain and abdominal distension were the most common clinical manifestations. Elevated alpha fetal protein (AFP) was observed in 93.5% patients. Surgery+adjuvant chemotherapy was applied in 33 patients. Twenty-seven patients received neoadjuvant chemotherapy+surgery+adjuvant chemotherapy

and 2 stage Ⅳ patients received chemotherapy alone. Six patients had poor response to chemotherapy and died of disease progression. The overall 3-year survival rate was 90.3%. The 3-year survival rate was 100% for stage Ⅰ-Ⅱ patients

83.3% for stage Ⅲ patients

65.6% for stage Ⅳ patients

and 66.7% for relapsed patients. Forty-one out of 48 patients in puberty age had regular menstrual cycles

6 patients had menstrual disorder

and 1 patient required hormone replacement therapy during the follow-up period.       Conclusion      The prognosis of malignant ovarian germ cell tumor is favorable. Surgery combined with platinum-containing chemotherapy can improve the efficacy and survival of the patients. Further investigation on novel and high-dose chemotherapy regimens is needed for the patients with stage Ⅳ

relapsed

and metastatic tumors. Sex hormone replacement therapy is not necessary for most patients received fertility-preserving surgery. The long-term potentia generandi of these patients needs further investigation.