Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, 107 West Wenhua Road, Ji'nan, Shandong, 250012, People's Republic of China.
Gynecology Oncology Key Laboratory, Qilu Hospital, Shandong University, Ji'nan, Shandong, 250012, People's Republic of China.
BMC Cancer. 2019 Mar 11;19(1):217. doi: 10.1186/s12885-019-5393-y.
0.17-2% of mature cystic teratoma of the ovary (MCTO) undergo malignant transformation, of which 80% are squamous cell carcinoma (SCC) transformation in MCTO. We aim to investigate the clinical characteristics and treatment of SCC transformation in MCTO METHODS: We systematically searched PubMed database and individual patient data about SCC transformation in MCTO were extracted. The published cases were combined with 6 cases of SCC transformation in MCTO from Qilu Hospital, Shandong University.
The incidence of SCC transformation in MCTO was 0.3%. A total of 435 cases of SCC transformation in MCTO were enrolled in the analysis. The mean age of diagnosis was 53.5 (range 19-87) years old. The most common clinical manifestations were abdominal pain (47.3%) and abdominal mass (26.0%). StageI,II, III and IV accounted for 50.0, 18.8, 26.8 and 4.4% of all cases, respectively. Patients with stage I had significantly better prognosis than stage II, III and IV patients (P < 0.01). Hysterectomy can improve overall survival (P < 0.01). For patients younger than 45 years old with stageIA orIC, there was no difference in mortality between fertility-sparing and radical surgery (P = 1.00). Adjuvant chemotherapy can improve survival in patients with advanced stage (P = 0.02), and chemotherapy with platinum was related to better prognosis (P = 0.02).
SCC transformation in MCTO is a rare malignancy mainly occurs in older age. FIGO stage is an independent prognostic factor. Hysterectomy and platinum-based chemotherapy are associated with better survival. Fertility-sparing surgery is feasible for young patients with early stage.
成熟囊性畸胎瘤（MCTO）的 0.17%-2%发生恶性转化，其中 80%为 MCTO 中的鳞状细胞癌（SCC）转化。我们旨在探讨 MCTO 中 SCC 转化的临床特征和治疗方法。
我们系统地检索了 PubMed 数据库，并提取了关于 MCTO 中 SCC 转化的个体患者数据。将已发表的病例与来自山东大学齐鲁医院的 6 例 MCTO 中 SCC 转化的病例相结合。
MCTO 中 SCC 转化的发生率为 0.3%。共有 435 例 MCTO 中 SCC 转化的病例纳入分析。诊断时的平均年龄为 53.5（范围 19-87）岁。最常见的临床表现为腹痛（47.3%）和腹部肿块（26.0%）。所有病例中Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期分别占 50.0%、18.8%、26.8%和 4.4%。Ⅰ期患者的预后明显优于Ⅱ期、Ⅲ期和Ⅳ期患者（P<0.01）。子宫切除术可改善总生存率（P<0.01）。对于年龄小于 45 岁且处于ⅠA 期或ⅠC 期的患者，保留生育功能手术与根治性手术在死亡率方面无差异（P=1.00）。辅助化疗可改善晚期患者的生存率（P=0.02），且含铂化疗与更好的预后相关（P=0.02）。
MCTO 中的 SCC 转化是一种罕见的恶性肿瘤，主要发生在老年患者中。FIGO 分期是独立的预后因素。子宫切除术和基于铂的化疗与更好的生存相关。对于年轻的早期患者，保留生育功能的手术是可行的。
