International Study of Primary Mucinous Ovarian Carcinomas Managed at Tertiary Medical Centers

Int J Gynecol Cancer. 2018 Jun;28(5):915-924. doi: 10.1097/IGC.0000000000001263.

Abstract

Objective: We sought to describe a large, international cohort of patients diagnosed with primary mucinous ovarian carcinoma (PMOC) across 3 tertiary medical centers to evaluate differences in patient characteristics, surgical/adjuvant treatment strategies, and oncologic outcomes.

Methods: This was a retrospective review spanning 1976-2014. All tumors were centrally reviewed by an expert gynecologic pathologist. Each center used a combination of clinical and histologic criteria to confirm a PMOC diagnosis. Data were abstracted from medical records, and a deidentified dataset was compiled and processed at a single institution. Appropriate statistical tests were performed.

Results: Two hundred twenty-two patients with PMOC were identified; all had undergone primary surgery. Disease stage distribution was as follows: stage I, 163 patients (74%); stage II, 8 (4%); stage III, 40 (18%); and stage IV, 10 (5%). Ninety-nine (45%) of 219 patients underwent lymphadenectomy; 41 (19%) of 215 underwent fertility-preserving surgery. Of the 145 patients (65%) with available treatment data, 68 (47%) had received chemotherapy-55 (81%) a gynecologic regimen and 13 (19%) a gastrointestinal regimen. The 5-year progression-free survival (PFS) rates were 80% (95% confidence interval [CI], 73%-85%) for patients with stage I to II disease and 17% (95% CI, 8%-29%) for those with stage III to IV disease. The 5-year PFS rate was 73% (95% CI, 50%-86%) for patients who underwent fertility-preserving surgery.

Conclusions: Most patients (74%) presented with stage I disease. Nearly 50% were treated with adjuvant chemotherapy using various regimens across institutions. The PFS outcomes were favorable for those with early-stage disease and lower but acceptable for those who underwent fertility preservation.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenocarcinoma, Mucinous / drug therapy
  • Adenocarcinoma, Mucinous / mortality
  • Adenocarcinoma, Mucinous / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chemotherapy, Adjuvant / statistics & numerical data
  • Denmark / epidemiology
  • Female
  • Fertility Preservation / statistics & numerical data*
  • France / epidemiology
  • Gynecologic Surgical Procedures / statistics & numerical data*
  • Humans
  • Middle Aged
  • New York City / epidemiology
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / surgery*
  • Retrospective Studies
  • Tertiary Care Centers / statistics & numerical data*
  • Young Adult