Malignant mixed mesodermal tumors of the ovary: a clinical analysis of 12 cases

Objective: To explore the clinical characteristics, treatment and prognostic factors of patients with malignant mixed mesodermal tumors of the ovary (MMMTO).

Methods: Clinical data of 12 patients with MMMTO between 1983-1997 were reviewed retrospectively. The median age of the patients was 50.7 years. According to FIGO staging system (1985), there were 4 cases in stage II, 6 in stage III and 1 in stage IV. Staging was unclear in the remaining case. Heterologous and homologous elements were present in the primary ovarian tumors in 4 and 8 of the 12 patients, respectively. All patients received cytoreductive surgery. Eleven of them received postoperative chemotherapy and 3 of these eleven patients received additional radiotherapy of pelvic field.

Results: The median survival of this group of 12 patients was 24 months. The 2- and 5-year survival rate was 33.3% (4/12) and 8.33% (1/12), respectively. The 2-year survival rate of stage II and III was 50% and 33.3% respectively. One patent in stage IV died within 1 year. Four of the 8 patients with homologous histology survived over 2 years while all the 4 cases with heterologous histology died within 2 years. Five of the 11 patients (45.5%) received combination therapy died within 1 year while 1 patient treated with surgery alone died within 6 months.

Conclusions: The prognosis of MMMTO is rather poor. Surgery combined with chemotherapy and/or radiotherapy seems to be a better choice of approach. The histological tpyes of tumor and stage of the disease are related to prognosis.