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Relatively Poor Survival of Mucinous Ovarian Carcinoma in Advanced Stage: A Systematic Review and Meta-analysis
  1. Michiel Simons, MD*,
  2. Leon Massuger, MD, PhD,
  3. Jolien Bruls, MD*,
  4. Johan Bulten, MD, PhD*,
  5. Steven Teerenstra, PhD and
  6. Iris Nagtegaal, MD, PhD*
  1. * Departments of Pathology,
  2. Obstetrics and Gynecology, and
  3. Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
  1. Address correspondence and reprint requests to Michiel Simons, MD, 824 Department of Pathology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: Michiel.Simons{at}


Objective Overall, patients with mucinous ovarian carcinoma (MOC) are considered to have a better prognosis compared with the whole group of nonmucinous carcinomas. However, some studies indicate that patients with advanced-stage MOC might have a worse prognosis than those with advanced-stage serous ovarian carcinoma (SOC). We carried out a systematic review and meta-analysis of the current literature.

Materials and Methods A comprehensive literature search was carried out identifying 19 articles that compare survival of patients with MOC and patients with SOC. Meta-analyses were performed for risk ratio (RR) and hazard ratio (HR) for all International Federation of Gynecology and Obstetrics stages together, as well as for early- and advanced-stage diseases separately.

Results Overall, patients with MOC showed a lower risk of dying within 5 years (RR, 0.67; 95% confidence interval [CI], 0.64–0.69; n = 45 333) and a longer survival (HR, 0.66; 95% CI, 0.58–0.75; HR, 0.88; 95% CI, 0.78–0.98, for univariate and multivariate analyses, respectively; n = 5540) compared with those with SOC. In contrast, in advanced-stage (International Federation of Gynecology and Obstetrics stages III and IV) disease, patients with MOC have a higher risk of dying within 5 years (RR, 1.15; 95% CI, 1.13–1.17; n = 36 113) and a shorter survival (HR, 1.82; 95% CI, 1.71–1.94; n = 19 907).

Conclusions Patients with advanced-stage MOC have a significantly worse prognosis compared with patients with SOC, whereas in early stage, the prognosis of patients with MOC is better.

  • Mucinous ovarian carcinoma
  • Serous ovarian carcinoma
  • Ovarian cancer
  • Survival
  • Meta-analysis

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  • The authors declare no conflicts of interest.