Real world study of 171 cases of mucinous ovarian carcinoma.

Abstract

e17583 Background: To provide a reference for the diagnosis and treatment of mucinous ovarian carcinoma (MOC), we retrospectively investigate its clinicopathological characteristics, diagnosis, treatment, and prognostic factors. We also explored the necessity of appendectomy in patients with primary mucinous ovarian carcinoma (pMOC), the safety of stage-I pMOC patients undergoing fertility-sparing surgery (FSS). Methods: We collected data of 171 patients diagnosed with MOC admitted to West China Second Hospital of Sichuan University from January 2011 to December 2020 from HIS system. Results: Age at diagnosis in pMOC patients was 40.16±5.03 and 49.51±5.79 in mMOC group (P < 0.05). Patients presented abdominal distension (50.9%), abdominal pain (42.7%), and abnormal vaginal bleeding (17.5%). mMOC patients had a significantly higher rate of difficulty urinating compared to pMOC patients (P < 0.05). Preoperative CA125 and CEA levels were significantly lower in pMOC patients than in mMOC patients (P < 0.05). CA199 levels were not significantly different between the two groups (P > 0.05). 87.8% of pMOC cases were unilaterally involved, while 12.2% had bilateral involvement. In mMOC, the proportions were 45.8% and 54.2%(P < 0.05). There was no significant difference in tumor size(14.0cm vs 13.0cm,P > 0.05).The rate of lymph node metastasis was significantly higher in mMOC patients (P < 0.05).24 patients (16.0%) recurred. The rate was 15.7% in pMOC patients (median PFS 16 months) and 18.8% in mMOC patients (median PFS 23 months).The recurrence rate was significantly higher in mMOC patients (P < 0.05).41 patients (27.3%) died.The mortality rate was significantly higher in mMOC patients (P < 0.05). In pMOC,61.2% received complete staging surgery or debulking, 21.8% had FSS, and 17.0% did not remove lymph node. 88.4% had appendectomy during primary surgery.5.4% had retroperitoneal lymph node metastasis.77.9% were in stage I, 3.3% in stage II, 15.5% in stage III, and 3.3% in stage IV. The difference in relapse and mortality rate between FSS and non-FSS group was not significant (P>0.05).Early-stage patients had significantly better PFS and OS than advanced-stage patients (P < 0.05),while they had comparable OS to mMOC patients (P > 0.05). Conclusions: mMOC patients were diagnosed at a younger age, had higher preoperative CA125 and CEA levels, more bilateral involvement, higher lymph node metastasis rates, and poorer PFS and OS. Most pMOC patients were diagnosed at an early stage and had a better prognosis. FSS is safe for stage I pMOC patients. Advanced pMOC had comparable OS to mMOC patients. Lymph node metastasis, bilateral involvement, Advanced FIGO stage and suboptimal cytoreduction were independent risk factors for pMOC patients. Appendectomy did not affect the prognosis of pMOC patients.