Introduction/Background Mucinous ovarian carcinoma (MOC) is a rare subset of epithelial ovarian cancers. Prognosis of MOC is better in early stages, but worse in advanced stages owing to inadequate chemo-response. Literature is heavily dependent on small-sampled retrospective studies due to the rarity of this tumour. Hence, we embarked on this analysis of outcomes of MOC in an Indian tertiary-care cancer centre. The main objectives were to correlate clinicopathological factors associated with MOC; to characterise primary vs metastatic MOC; to assess role of appendicectomy and fertility-sparing surgery, and to analyse survival outcomes (progression-free survival – PFS and overall survival – OS).
Methodology Retrospective study of women diagnosed with MOC and treated from our tertiary-care cancer centre over a 10-year period; from January 2008 to December 2017. Patient records were reviewed, details assessed and data regarding recurrences and survival were analysed.
Results 109 patients were included in the study. Primary staging was done in 62%. 88% presented at stage I. 75% had primary ovarian mucinous histology, while 25% had metastatic histology. Metastatic MOC had absent borderline areas and advanced stage. 32% underwent appendicectomy, 2 cases had positive appendices and both were grossly abnormal. 23 patients recurred – 12 intraperitoneal, 8 extra-abdominal. Median follow-up of 49 months and 3-year PFS and OS were 70.2% and 77.9%. Early-stage MOC – median OS was not reached. Metastatic carcinomas had significantly poorer OS compared to advanced primary (10 vs 41 months p-<0.001). Fertility-sparing surgery with only ovarian cystectomy significantly reduced OS compared to adnexectomy.
Conclusion Of 109 MOCs, most had primary histology and early stage. Metastatic carcinoma had absent borderline areas, smaller size, bilaterality and advanced stage. Routine appendicectomy may not have a prognostic role. Factors affecting OS were the stage of disease and extent of surgery; not chemotherapy regime. Ovarian cystectomy alone resulted in poorer survival.
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