Oncological Outcomes of Immature Ovarian Teratoma: A 15-Year Report From a Cancer Center

Immature ovarian teratomas (IOTs) are a rare ovarian tumor, with recurrence rates varying widely depending on age and grade. Thus far, debate exists regarding the management of IOTs, especially of their recurrences.

To review clinical characteristics and oncological outcomes of immature ovarian teratoma following primary and secondary surgery.

This retrospective cohort study was conducted in the department of surgical oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan, between July 2008 and June 2023 (15 years). All patients with pathological confirmation of IOTs were included in the study. Women were excluded if (1) details of baseline characteristics or primary treatment were unavailable, and (2) if there was no follow-up data. Non-probability consecutive sampling technique was used for the recruitment of patients. Patient demographics and disease characteristics were summarized using descriptive statistics. Progression-free survival time and overall survival were calculated from the time of surgery to the date of recurrence or the date of death. The Kaplan-Meier method was used for survival curves. Statistical analysis was performed using Statistical Product and Service Solutions (SPSS, version 23; IBM SPSS Statistics for Windows, Armonk, NY).

Of 37 women, most of the patients belonged to an age group of 21-30 years (N-16, 43.2%). Stage 1a (N-18, 48.6%) and grade III disease (N-12, 32.4%). Laparotomy was performed in 91.9% (N-34) of the patients. The majority of the patients underwent unilateral salpingo-oophorectomy (N-27, 73%). Twenty-seven patients received adjuvant chemotherapy (73%). Relapse occurred in 31.5% (N-13) of the patients. However, the most common site of relapse was the liver (N-5, 13.5%). Secondary cytoreductive surgery was done in eight (61.5%) patients, while the rest of the cohort received adjuvant chemotherapy. Overall survival after a mean follow-up of 43 months was 81%.

IOT occurs most commonly in young women. The most common presentation is early stage but high grade, and fertility-sparing surgery has good oncological outcomes. With secondary cytoreductive surgery and platinum-based chemotherapy, it is possible to salvage most recurrences.