Objectives To compare the clinical-pathological features and survival outcomes of women with serous and non-serous epithelial ovarian cancer.

Methods Retrospective study of 151 patients staged surgically in Salah Azaiez Tunisian cancer center, between 2000 and 2010.

Results We performed primary debulking surgery in 128 patients (84.8%) and 23 patients (15.2%) underwent and interval debulking surgery.Maximal cytoreduction (R0) was achieved in 67 of patients (44.4%),39 patients had a residual disease ≤1 cm (25.8%) and 45 patients had a residual disease >1 cm (28.8%).Lymphadenectomy was performed in 57% of cases.The histological type was clearly established for all women:109 cases of serous carcinomas (72.2%) and 71 non-serous tumors (14 endometrioid,12 mucinous,7 clear cell carcinomas,2 malignant Brenner tumors,6 undifferentiated and one case of seromucinous carcinoma).The comparison of serous (SEOC) to non-serous tumor types (NSEOC) by univariate analysis showed that SEOC were associated to higher serum level of CA 125 exceeding 1000UI/ml (47.7% vs 19%,p=0.001), higher quantity of ascites exceeding 1 litre (40.4% vs 21.4%,p=0.029) with more frequent cacinomatosis in the upper abdomen (48.6% vs 21.4%,p=0.002) and more residual disease R1/R2 (65.1% vs 31%,p<0.0001),bilateral tumors (74.1% vs 45.2%,p=0.001),advanced FIGO stage III-IV (88.1% vs 50%,p<0.0001),pelvic lymph metastasis (LNM) (11.7% vs 4.2%) as well as paraaortic LNM (16.7% vs 8.3%,p=0.012),higher LN ratio (12.57±21.96 vs1.77±5.62,p=0.01) and lymphovascular invasion (43.1% vs 9.5%,p<0.0001). NSEOC were associated to higher rates of 5-years overall survival (31.3% vs 54.2%,p=0.006) and recurrence free survival (31.8% vs 64.6%,p=0.002).

Conclusion The management of EOC should take into account differences between histological subtypes.