Prognosis of stage I ovarian mucinous tumors according to expansile and infiltrative types.

OBJECTIVE

Mucinous ovarian carcinomas account for 3% of all epithelial ovarian carcinomas and are categorized into expansile or infiltrative subtypes. Nevertheless, the prognostic impact of these subtypes in stage I disease remains unclear.

METHODS

This retrospective study included patients with mucinous ovarian cancer who were referred to or treated at our institution between 1976 and 2022. Pathologic review was performed by 2 expert pathologists. Only patients with stage I disease were included in this study. Tumors were characterized as expansile or infiltrative, and oncologic features were analyzed.

RESULTS

A total of 80 cases met the inclusion criteria, with 36 and 44 patients having expansile and infiltrative subtypes, respectively. The disease stages were as follows: expansile subtype in 14 patients, stage IC in 22 patients, infiltrative subtype stage IA in 26 patients, and stage IC in 18 patients. The characteristics of the 2 groups of patients were comparable, except for the use of lymphadenectomy (more frequent in the infiltrative subtype: 28/44 [63%] vs 8/36 [22%] in expansile disease, p < .05). After a median follow-up of 79 months (range; 27.7-119.2), 10 (12.5%) recurrences occurred (3 expansile and 7 infiltrative). A total of 2 cases of expansile recurrence with pelvic recurrence were cured after secondary surgery and chemotherapy, and 1 patient died of the disease. A total of 5 patients with infiltrative recurrence had extra-pelvic spread and died of the disease, 1 patient was still alive with progressive disease, and the last was still alive and disease-free. A total of 2 cases of recurrence were observed after conservative surgery (1 of each subtype).

CONCLUSIONS

In this series, the overall and disease-free survival rates were not significantly different between patients with expansile and infiltrative stage I mucinous ovarian carcinoma. However, the prognosis of recurrent infiltrative cases is poorer than expansile cases.