Abstract

Primary Ovarian Malignant Mixed Mullerian Tumour: Analysis of 17 Cases and Review of the Literature

Tounsi Nesrine, Chemlali Molka, Abdelwahed Nawel, Triki Amira, Doghri Rhaoudha, Ben Hassouna Jamel and Rahel Khaled

Introduction: Carcinosarcomas called also malignant mixed Mullerian tumors (MMMTs) are rare tumors with a poor prognosis and fast progression. Due to the rarity of MMMTs, only a few studies were published up to now.
Material and method: We report 17 cases of ovarian carcinosarcoma identified from 2000–2014 through tumor registry and pathology records from our institute (Salah Azaiz Tunisia). Fisher exact test was used to compare categorical variables. The Kaplan–Meier method was used to calculate survival. P values of <0.05 were considered statistically significant.
Result: All 17 patients underwent initial surgical treatment. Stage distribution was as follows: 3 stage I, 1 stage II, 11 stages III, and 2 stages IV. After surgery, 5 patients had no residual tumor with complete surgical staging. An improved survival was observed in patients treated with optimal cytoreductive surgery with no residual tumor (p=0.04). The majority of patients’ demonstrated homologous histology. No difference in survival was observed between the two groups (p=0.386). All patients but tow underwent adjuvant chemotherapy. During the first year, 30% of patients died of the disease. OS for early stage (stages I and II) was better than OS for advanced stage (stages III and IV) (P=0.386).
Conclusion: We think that aggressive surgical treatment with optimal cytoreductive and no residual tumor may play an important role to achieve better results. However, other alternative systemic therapeutic approaches should be sought for patients with carcinosarcoma of the ovary.