Malignant mixed mullerian tumors of the ovary: histopathologic and clinical review of 36 cases

Among 2,895 malignant ovarian tumor cases referred to Radiumhemmet, Stockho lm from 1975 through 1995, 36 were certified to be malignant mixed mulleria n tumors. The overall prognosis was poor with only 18% five-year actuarial survival (median survival 16.6 months). Five patients are still surviving a fter 75, 68, 117, 121, and 168 months, respectively. Fifteen women treated with melphelan, doxorubicin (adriamycin) and cisplatin (MAP) had a five-yea r actuarial survival of 33.3% and a median survival of 19.8 months. In a mu ltivariate analysis taking into account stage, age, radiation, type of chem otherapy, histopathologic type and completeness of surgery, the most import ant predictors for survival were stage (stages I-II vs stages III-IV, P < 0 .05), histopathologic type (homologous vs heterologous, P < 0.05), and type of chemotherapy (MAP or CAP vs other types, P < 0.05). We concluded that h omologous tumor and chemotherapy containing cisplatin, doxorubicin, and mel phalan, as well as early stage of the tumor, provided the optimal survival rate.