Clinicopathologic Studies in Patients with Ovarian Mucinous Cystadenocarcinoma

Seong, Won Joon; Chong, Gun Oh; Kim, Byung Yoon; Park, Il Soo

Abstract

OBJECTIVE
To evaluate the clinicopathologic features and clinical outcomes in patients with mucinous cystadenocarcinoma.
METHODS
After review of charts in 36 patients from January 1995 to March 2002, data including clinical finding, treatment and outcome were analyzed.
RESULTS
The mean age of patients with mucinous cystadenocarcinoma was 46.8 years old, 30 women (83.3%) of them were parous and 13 women (36.1%) were postmenopuase. Bilaterality was 10 cases (27.8%), and mean size of carcinoma was 15.7 cm. The chief complaints of patients were 12 cases (33.3%) of abdominal discomfort or pain, 11 cases (30.6%) of abdominal distension, 5 cases (13.9%) of palpable mass, and 5 cases (13.9%) of asymtomatic. Mean interval from the onset of symptom to the diagnosis was about 6 months. Positive cytology of ascites or peritoneal washing fluid was seen in 6 cases (27.3%). Metastases of omentum were 8 cases (22.2%), 6 cases (16.7%) of peritoneum, 6 cases (16.7%) of rectosigmoid colon, 5 cases (13.9%) of appendix, 2 cases (5.6%) of uterus, 2 cases (5.6%) of pelvic lymph node, 1 case (2.8%) of paraaortic lymph node, 1 case (2.8%) of diaphragm. Of 36 cases, total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy was performed in 22 cases (61.1%). Chemotherapy was performed in 33 cases (91.7%), most favored regimen was combination of paclitaxel and platinum based agents (cisplatin or carboplatin). According to FIGO staging, there were 21 cases (58.3%) of stage I, 1 case (2.8%) of stage II, 9 cases (25.0%) of stage III, and 5 cases (13.9%) of stage IV. Second look operations were done in 10 cases (27.8%), 6 cases (60.0%) of 10 cases were progressive disease. Mean duration of follow up was 31.9 months. Among 34 patients (94.4%) of follow-up, 9 patients (26.4%) were expired and 3 year survival rate was 58.8%.
CONCLUSION
Mucinous cystadenocarcinoma represents a major surgical challenge, which requires intensive and complex therapies, and highest fatality-to-case ratio of all the gynecologic malignancies. Early diagnosis and effective surgery with adjuvant chemotherapy were essential for patients' long survival.