J Gynecol Oncol.  2018 May;29(3):e37. 10.3802/jgo.2018.29.e37.

Retrospective analysis of sites of recurrence in stage I epithelial ovarian cancer

Affiliations
  • 1Department of Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, Kashiwa, Japan. htanabe@jikei.ac.jp
  • 2Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan.
  • 3Department of Obstetrics and Gynecology, The Jikei University Katsushika Medical Center, Tokyo, Japan.
  • 4Department of Obstetrics and Gynecology, The Jikei University Daisan Hospital, Tokyo, Japan.

Abstract


OBJECTIVE
The aim of the study is to investigate recurrence of stage I epithelial ovarian cancer.
METHODS
Six hundred two patients diagnosed with stage I epithelial ovarian cancer at 4 hospitals between 2000 and 2013 were retrospectively analyzed. Age, surgical procedure, substage, histologic type, adjuvant chemotherapy, recurrence, initial recurrence site (peritoneal dissemination [P], hematogenous recurrence [H], lymphogenous recurrence [L], and others [O]), and frequency of recurrence at each site were investigated retrospectively.
RESULTS
Median age was 54 years and median follow-up was 60 months. The stage was IA in 180 cases (30%), IB in 8 (1%), IC1 in 247 (41%), IC2 in 63 (10%), and IC3 in 104 (17%). Systematic lymph node dissection including both pelvic and para-aortic lymph nodes was performed in 224 patients (37%), and 412 patients (68%) received adjuvant chemotherapy. Recurrence occurred in 70 patients (11.6%). The median time to recurrence was 18 months, and the stage was IA in 13 (19%), IB in 1 (1%), IC1 in 24 (34%), IC2 in 9 (13%), and IC3 in 23 (33%) cases. The numbers of recurrence at the P, H, L, and O sites, including overlapping cases, were 49 (70%), 18 (26%), 9 (13%), and 6 (9%), respectively, and recurrence by peritoneal dissemination in the pelvis occurred in 43 cases (61%).
CONCLUSION
Recurrence of stage I epithelial ovarian cancer by peritoneal dissemination was frequent, especially in the pelvis. There is a need to elucidate the pathogenesis of peritoneal recurrence and to prepare a treatment strategy to prevent pelvic peritoneal recurrence.

Keyword

Ovarian Neoplasms; Recurrence; Neoplasm Metastasis; Neoplasm Seeding

MeSH Terms

Chemotherapy, Adjuvant
Follow-Up Studies
Humans
Lymph Node Excision
Lymph Nodes
Neoplasm Metastasis
Neoplasm Seeding
Ovarian Neoplasms*
Pelvis
Recurrence*
Retrospective Studies*
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