SQUAMOUS-CELL CARCINOMA ARISING IN MATURE CYSTIC TERATOMA OF THE OVARY

Treatment results of 26 patients with squamous cell carcinoma (SCC) ar ising in mature cystic teratoma of the ovary were analyzed. Four nulli parous patients with stage Ia tumors underwent conservative salpingo-o ophorectomy. Following surgery, 2 patients had successful pregnancies. The remaining 7 patients with stage Ia tumors were observed after hys terectomy and bilateral salpingo-oophorectomy. Fifteen patients with s tage Ic-IV tumors underwent cytoreductive surgery followed by cis-plat inum-based chemotherapy with or without sequential radiotherapy. The m ean survival was 63.9 months. The overall actuarial disease-free survi val at 2 years was 69%, and by stage was as follows: stage I, 100% (13 /13); stage II, 100% (2/2); stage III, 30% (3/10); and stage IV, 0% (0 /1). A significant difference in disease-free survival was noted in st age (P=0.0001). Optimal versus suboptimal operation was associated wit h a median Kaplan-Meier survival of 65 months versus 34.8 months, with actuarial disease-free survival at 2 years of 60 and 0%, respectively (P=0.0210). Our study shows that 67% (16/24) of the patients had SCC antigen levels exceeding 2 ng/ml, which by stage was as follows: stage I, 5/11 (45%); stage II, 1/2 (50%); stage III, 9/10 (90%); and stage IV, 1/1 (100%). After completion of treatment, all 8 patients with rec urrent lesions had reelevated SCC antigen levels in series SCC antigen monitoring. In conclusion, positive prognostic factors of disease-fre e survival were optimal cytoreduction and lower FIGO stage. We uggest that multimodality therapy, including aggressive cytoreduction followe d by cis-platinum-based chemotherapy with or without sequential radiot herapy, is recommended. In addition, we suggest that serum SCC antigen monitoring may be helpful in early detection of cancer recurrence. (C ) 1996 Academic Press, Inc.