Ovarian carcinoma presents as distant metastases without detectable tumors of the origin disease at the first presentation / 中华妇产科杂志

ABSTRACT

Objective To study the characteristics, therapies and prognosis of the patients with epithelial ovarian cancer (EOC) that are initially categorized as extra abdominal adenocarcinoma of unknown primary Methods Twenty five patients with EOC, who were treated in the Cancer Hospital of Fudan University from Jan 1986 to Dec 1997, and manifesting as extra peritoneal or liver parenchyma metastases at the time of presentation, without detectable ovarian tumors, were retrospectively studied Results Supraclavicular and inguinal lymph node metastases were common in this group of patients, with 6 and 5 cases respectively, and 6 patients with more than two sites metastases simultaneously 16 patients (64%) were optimally surgical debulked 20 patients with stage Ⅳ EOC initially presenting as extra abdominal metastases experienced a better prognosis, with an estimated median survival of 24 months. Of whom the median survival was 30 months in patients presenting with pleural effusion or supraclavicular lymph node metastases Vs 19 months in those with other sites spread ( P =0 026 4) Conclusions The prognosis of such cases, particularly for those with supraclavicular lymphadenopathy or malignant pleural effusion, is a lot better than other stage Ⅳ EOC patients, probably because of most of the patients initially presenting with distant metastases being generally in a good condition competent for aggressive surgery or multi cycle chemotherapy