Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1 Seiryo machi, Aoba ku, Sendai 9808574, Japan.
Int J Gynecol Cancer. 2010 Jul;20(5):766-71. doi: 10.1111/igc.0b013e3181daaf1d.
Mature cystic teratoma (MCT) of the ovary rarely undergoes malignant transformation (MT). Malignant transformation carries a significantly worse prognosis than epithelial ovarian cancer, regardless of whether postoperative chemotherapy or radiotherapy is applied. The rarity of this tumor has posed a significant challenge to developing standardized postoperative management protocols. The aim of this study was to review our experience with MT and to describe our current treatment practices.
A retrospective chart review of these patients was performed that identified 20 women treated for MT of MCT at our centers between 1988 and 2008.
The median age was 52.5 (range, 29-77) years. Fifteen patients had squamous cell carcinoma (SCC), and 5 patients had other histological subtypes. The International Federation of Gynecology and Obstetrics stage distribution was as follows: 11 were stage I, 4 were stage II, 4 were stage III, and 1 was stage IV. All patients underwent an initial laparotomy. Eleven patients received adjuvant treatment: 8 were treated with chemotherapy, 2 with concurrent chemoradiation therapy, and 1 with radiation therapy. Platinum-based chemotherapy was the first-line regimen. The overall 1-year survival rate was 70%. Significant correlations between overall survival and age, stage, and residual tumor were presented (P = 0.044, P = 0.0107, P < 0.0001, respectively). Eight patients with advanced stage died of their disease. Four patients, however, were treated with adjuvant chemotherapy or concurrent chemoradiation therapy and survived more than 1 year. One stage III patient had a disease-free interval of 2 years. Two cases of SCC treated with combination platinum/taxane chemotherapy temporarily responded. In the other 2 cases of SCC, concurrent chemoradiation therapy with nedaplatin also resulted in tumor regression.
The prognosis of MT is highly dependent on age, stage, and optimal cytoreduction. Adjuvant treatment has not been standardized, although our experience supports the use of combination platinum/taxane chemotherapy.
成熟囊性畸胎瘤（MCT）很少发生恶性转化（MT）。无论术后是否应用化疗或放疗，恶性转化的预后明显比上皮性卵巢癌差。由于这种肿瘤罕见，制定标准化的术后管理方案具有挑战性。本研究的目的是回顾我们对 MT 的经验，并描述我们目前的治疗实践。
对我们中心 1988 年至 2008 年间治疗的 20 例 MCT 恶性转化患者进行回顾性图表审查。
中位年龄为 52.5 岁（范围，29-77 岁）。15 例为鳞状细胞癌（SCC），5 例为其他组织学亚型。国际妇产科联合会（FIGO）分期分布如下：11 例为 I 期，4 例为 II 期，4 例为 III 期，1 例为 IV 期。所有患者均行初次剖腹术。11 例患者接受辅助治疗：8 例接受化疗，2 例接受同期放化疗，1 例接受放疗。顺铂为一线治疗方案。总 1 年生存率为 70%。总生存率与年龄、分期和残留肿瘤之间存在显著相关性（P = 0.044，P = 0.0107，P < 0.0001）。8 例晚期患者死于疾病。然而，有 4 例患者接受了辅助化疗或同期放化疗，生存时间超过 1 年。1 例 III 期患者无疾病间隔 2 年。2 例 SCC 患者接受联合顺铂/紫杉醇化疗后暂时缓解。在另外 2 例 SCC 中，奈达铂同期放化疗也导致肿瘤消退。
MT 的预后高度依赖于年龄、分期和最佳减瘤术。辅助治疗尚未标准化，尽管我们的经验支持使用联合顺铂/紫杉醇化疗。
