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. 2019 Jan 14:15:129-136.
doi: 10.2147/TCRM.S190641. eCollection 2019.

Experience of applying cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for ovarian teratoma with malignant transformation and peritoneal dissemination

Hsin-Hsien Yu  1   2 , Yutaka Yonemura  3   4 , Mao-Chih Hsieh  2   5 , Chang-Yun Lu  2 , Szu-Yuan Wu  6   7 , Yan-Shen Shan  1   8
Affiliations

Experience of applying cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for ovarian teratoma with malignant transformation and peritoneal dissemination

Hsin-Hsien Yu et al. Ther Clin Risk Manag. .

Abstract

Objectives: The prognosis of ovarian teratoma with malignant transformation and peritoneal dissemination (PD) is poor. This condition is rare but associated with a high recurrence rate even after aggressive debulking surgery and adjuvant chemotherapy. In the present paper, we describe our experience of using cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for this condition.

Methods: The data of ten female patients having ovarian teratoma with malignant transformation and PD between June 2007 and June 2017 were collected and reviewed retrospectively. CRS-HIPEC was performed according to the standard protocol. Patient characteristics, pathological reports, tumor markers, perioperative operative parameters, postoperative events, and disease status during the follow-up period were recorded.

Results: The primary ovarian neoplasms were pure mature cystic teratoma with malignant transformation (n=6, including 5 of mucinous adenocarcinoma), mixed germ cell tumor with mature cystic teratoma and yolk sac tumor (YST) (n=1), pure immature teratoma (n=1), immature teratoma with growing teratoma syndrome (GTS) (n=1), and immature teratoma mixed YST with GTS (n=1). The mean levels of tumor markers, including carcinoembryonic antigen, cancer antigen 19-9 (CA19-9), and CA125, were markedly elevated. The recurrence rate was 10%. The median and mean disease-free survival (DFS) after CRS-HIPEC were 22.3 and 36.2 months, respectively, and the 5-year DFS rate is 88%.

Conclusion: CRS-HIPEC is a safe therapeutic option for reducing the recurrence rate in selected patients with PD originating from ovarian teratoma with malignant transformation.

Keywords: cytoreductive surgery; hyperthermic intraperitoneal chemotherapy; malignant transformation; ovarian teratoma; peritoneal dissemination.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Comparison of survival curve of HIPEC group vs non-HIPEC standard treatment group; The HIPEC group showed a higher 5-year DFS rate (88%) than the standard group (40%) (P=0.119). Abbreviations: HIPEC, hyperthermic intraperitoneal chemotherapy; DFS, disease-free survival.
See this image and copyright information in PMC

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