Treatment and Prognosis of Malignant Ovarian Tumors

• Published in: Iryo Vol. 23; no. 4; pp. 516 - 525
• Main Authors: IMAIZUMI, Shizuo, SUZUOKI, Yozo, TORII, Kazutoshi, YAMAGISHI, Hideyo
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of National Medical Services 1969
• Subjects: Adenocarcinoma - therapy; Adolescent; Adult; Aged; Cystadenocarcinoma - therapy; Cystadenoma - therapy; Dysgerminoma - therapy; Female; Humans; Middle Aged; Ovarian Neoplasms - therapy; Prognosis; Teratoma - therapy
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.23.516

From January, 1961 to December, 1965, we treated 28 malignant ovarian tumors, 9.6% of all operated ovarian tumors in our Nagoya National Hospital. The classification of malignant ovarian tumor was as follows; dysgerminoma 4; malignant teratoma 2; primary ovarian carcinoma 16 ; metastatic ovarian carcinoma 6. 1. Dysgerminoma and malignant teratoma. In all cases, the tumor was confined to the ovary. Therefore, unilateral salpingooophorectomy and chemotherapy offered favorable prognosis. 2. Primary ovarian carcinoma. In all cases, diagnosis was confirmed at laparotomy. The scheme proposed by Jikei University was employed for clinical classification. The distribution of cases in this series was stage I, 3 cases; stage II, 6 cases; stage III, 7 cases. The standard therapy of these tumors was surgical removal combined with postoperative irradiation and chemotherapy. The nature of surgery was determined by the extent of the disease. Each number of initial surgery was as follows; 1 hysterectomy and bilateral salpingo-oophorectomy, 6 supracervical hysterectomy and bilateral salpingo-oophorectomy, 7 bilateral salpingo-oophorectomy, 2 exploratory laparotomy. The 16 cases were treated with abdominal surgery and postoperative chemotherapy. 15 cases of them were treated with Tespamin. The drug, in dosis of 10mg, was given intraperitoneally at laparotomy and then 5 mg daily intramusculary for 18 days, that means total amount reached to 100mg. Mitomycin and Endoxan were used in a few cases. Postoperative irradiation of 60Co was performed in 12 of 16 cases. In the majority of these cases, dose of 5, 000r or more was given within 6 or 8 weeks. 8 patients, 50% of them were dead within one year. Only 2 patients survived for 5 years. In addition, 3 patients are still alive now after 3 or 4 years. (October, 1967) 3. Metastatic ovarian carcinoma. In 5 of 6 patients, metastatic carcinoma developed during the course of gastrointestinal carcinoma. All of these cases were dead within one year. One patient of metastatic carcinoma, originated from cervical carcinoma, was treated with operation, postoperative irradiation and chemotherapy. In spite of incomplete surgical removal of pelvic carcinoma, the patient survived, and now well after 4 years and 6 months. Conclusion: As generally accepted idea, prognosis of malignant ovarian tumor was related rather to the extent of abdominal involvement and the degree of histologic maturation than to the ways of treatment.