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Estrogen and progesterone receptors in malignant mixed mesodermal tumors of the ovary
J P Geisler1, M C Wiemann, G A Miller
1Department of Obstetrics and Gynecology, St. Vincent Hospital and Health Care Center, Indianapolis, IN 46260, USA.
Abstract:
Malignant mixed mesodermal tumors of the ovary occur in less than 1% of cases of ovarian cancer. They have a dismal prognosis and the most effective type of therapy is still not known. All cases of malignant mixed mesodermal tumor of the ovary between January 1, 1985 and May 1, 1994 operated on by the gynecologic oncology service are the subject of this report. Data were obtained from the hospital and office records of the patients. Nine patients who had their primary surgery by the gynecologic oncology service were found to have the diagnosis of malignant mixed mesodermal tumor of the ovary. Homologous tumors were found in five patients and heterologous tumors in four. Homologous tumors (mean survival 15.2 months) showed a better survival than heterologous tumors (mean survival 6.5 months; P = 0.001). An elevated estrogen receptor status was shown to correspond to longer survival (P < 0.0001). Six specimens were considered to be estrogen receptor positive and three were receptor negative. The mean survival in those patients who had a positive estrogen receptor status, 13.7 months, with a median of 7.5 months was significantly higher than those who were not positive, 6.7 months (P = 0.019) with a median of 6.25 months. All specimens were progesterone receptor negative. Malignant mixed mesodermal tumors of the ovary have a dismal prognosis, no effective therapy, and controversial prognostic indicators. Increasing estrogen receptor status appeared to correlate with longer mean survival. Larger, multi-institutional studies need to be done to determine the overall significance of these findings.
Insights
Malignant mixed mesodermal tumors of the ovary are rare and have a poor prognosis. Higher estrogen receptor status in these ovarian cancers may correlate with longer survival, but further research is needed.
Area of Science:
- Gynecologic Oncology
- Pathology
- Reproductive Endocrinology
Background:
- Malignant mixed mesodermal tumors (MMMTs) of the ovary are rare, accounting for less than 1% of ovarian cancers.
- These tumors present a dismal prognosis with currently unknown optimal therapeutic strategies.
Purpose of the Study:
- To investigate prognostic indicators in ovarian malignant mixed mesodermal tumors.
- To evaluate the correlation between tumor characteristics and patient survival.
Main Methods:
- Retrospective analysis of nine patients diagnosed with ovarian MMMT between 1985 and 1994.
- Data collected from hospital and office records, including tumor type (homologous vs. heterologous) and estrogen receptor (ER) status.
Main Results:
- Homologous tumors demonstrated significantly better survival (mean 15.2 months) compared to heterologous tumors (mean 6.5 months).
- Positive estrogen receptor status correlated with significantly longer mean survival (13.7 months) versus negative status (6.7 months).
- All specimens were progesterone receptor negative.
Conclusions:
- Ovarian MMMTs have a poor prognosis with controversial prognostic factors.
- Elevated estrogen receptor status may be a favorable prognostic indicator for survival in ovarian MMMT.
- Larger, multi-institutional studies are warranted to confirm these findings and guide treatment.