Characteristics, treatment and outcomes of women with immature ovarian teratoma, 1998–2012

Objective To explore the presentation, management and outcomes of adult women diagnosed with immature ovarian teratoma. Methods The National Cancer Database (NCDB) was used to identify women ≥ 18 years of age diagnosed with an immature teratoma from 1998 to 2012. We analyzed demographic, clinical and tumor characteristics, and treatment trends. Multivariable models were employed to examine predictors of adjuvant chemotherapy use and survival. Results We identified a total of 1045 adult women with immature teratoma. The median age of diagnosis was 27 years and most were diagnosed between ages 18 and 39 (88.9%). The majority presented with early-stage (I/II) disease (76.0%), underwent unilateral salpingo-oophorectomy (52.5%) and received adjuvant chemotherapy (56.8%). The probability of receiving chemotherapy increased with stage, grade, and treatment at academic compared to community based centers (P < 0.05.). Older age, advanced stage, and grade III histology were associated with worse survival (P < 0.05). Five-year survival rates were: 98.3% (95% CI 96.8–99.1), 93.2% (95% CI 82.8–97.4), 82.7% (95% CI 74.3–88.5), and 72.0% (95% CI 50.1–85.5) for stages I, II, III, and IV disease, respectively. Conclusions The incidence of immature teratoma is highest in young adults aged 18 to 39. Most patients present with early-stage disease, are managed with fertility sparing surgery and chemotherapy and have an excellent prognosis. Later age at diagnosis, advanced stage, and high-grade histology confer a worse prognosis.