[Clinical features and prognostic factors of malignant ovarian teratoma]

To assess the clinical features and prognostic factors of malignant ovarian teratoma.

Eighty-four patients with malignant ovarian teratoma between 1954 and 2001 were studied retrospectively. All patients were treated with surgery, the mid-period of follow-up was 146 months. Patient characteristics, surgical therapy, pathologic diagnosis, histological grade, and follow-up data were extracted and survival curves were depicted. Statistical analysis was performed using SPSS software version 10.0.

The average age was (33.5 +/- 16.1) years. Abdominal pain and abdominal extension were the main complaint. Thirty-seven women were diagnosed with malignant transformation of ovarian teratoma while 47 were of ovarian immature teratoma. Clinical stage was the only prognostic factor with significantly statistical differentiation. Five-year survival rate of malignant ovarian teratoma with stage I, II, III, and IV were (87.20 +/- 4.52)%, (50.00 +/- 35.36)%, (30.55 +/- 9.43)%, and 0.00%, respectively (P = 0.00). Five-year survival rate of ovarian immature teratoma with histological grade I, II, and III were (90.48 +/- 6.41)%, (68.75 +/- 11.59)%, and (57.14 +/- 16.38)%, respectively (P = 0.08). Among 31 women died of malignant ovarian teratoma, 27 (87.1%) died within 2 years after operation.

This retrospective study suggests that malignant transformation of ovarian teratoma is clinically different from ovarian immature teratoma. Complete staging surgery or Debulking surgery followed by 4-6 courses adjuvant chemotherapy with cisplatin, vincristine, and bleomycin are the principle treatment. Conservative surgery may well improve the life quality of younger patients. All patients should be closely followed up for at least 2 years.