Complete staging surgery and radioiodine therapy were predictive of disease progression of malignant struma ovarii: a retrospective study from a single-center in China and literature review

Malignant struma ovarii (MSO) is a rare subtype of ovarian cancer. We aimed to evaluate the role of complete staging surgery (CSS) and adjuvant radioiodine therapy in this rare malignancy. MSO patients with sufficient information who were treated at the Cancer Hospital & Institution of Chinese Academy of Medical Sciences were retrieved. We also considered studies published in English and listed on PubMed up to December, 2024. Studies were eligible for inclusion if they reported individual information of patients with MSO. Clinicopathological and follow-up data were retrospectively collected for each individual patient. Univariate and multivariate analyses were conducted to investigate potential prognostic factors. A total of 203 cases were enrolled in this analysis. MSO was mainly found in premenopausal women younger than 50 years. Most patients (68/93, 73.1%) were diagnosed with early-stage disease (FIGO stage I and II). The median progression-free survival (PFS) was 36.0 months (range, 1.0-444.0 months) and the median overall survival (OS) was 54.0 months (range, 1.0-456.0 months). FIGO stage, complete staging surgery, and adjuvant radioiodine therapy were independent prognostic factors for PFS in MSO patients. No independent risk factor was identified for OS in MSO patients. Advanced FIGO stage might serve as an independent risk predictor for disease progression in MSO patients. Complete staging surgery and adjuvant radioiodine therapy might reduce tumor recurrence in MSO. Further large-scale well-designed studies are needed to verify our results.