TY - JOUR T1 - Impact of Abdominal Wall Metastases on Prognosis in Epithelial Ovarian Cancer JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1594 LP - 1600 DO - 10.1097/IGC.0000000000000826 VL - 26 IS - 9 AU - Beyhan Ataseven AU - Andreas du Bois AU - Philipp Harter AU - Sonia Prader AU - Christoph Grimm AU - Christian Kurzeder AU - Stephanie Schneider AU - Sebastian Heikaus AU - Anett Kahl AU - Alexander Traut AU - Florian Heitz Y1 - 2016/11/01 UR - http://ijgc.bmj.com/content/26/9/1594.abstract N2 - Objective Epithelial ovarian cancer (EOC) patients with the presence of abdominal wall metastasis (AWM) are categorized as stage International Federation of Gynecology and Obstetrics (FIGO) IVB, irrespective of other biologic factors or preceding invasive intervention before final surgery. We evaluated the impact of AWM on patients’ overall survival (OS).Patients and Methods In this exploratory study, 634 consecutive patients with advanced EOC treated in our center from 2000 to 2014 were included. Patients were categorized into FIGO IIIC (n = 308), FIGO IVB AWM only (n = 86), and FIGO IV others (metastases other than AWM, n = 240). Clinicopathological parameters and survival data were extracted from our prospectively maintained tumor registry. Survival analyses were calculated using Kaplan-Meier method and Cox regression models.Results In 75 (87.2%) of 86 cases, AWM was seen after a preceding intervention, and only in 12.7%, the deposits were spontaneously established. The median OS in patients with stage FIGO IIIC, FIGO IVB AWM only, and FIGO IV others was 37, 58, and 25 months (P < 0.001), respectively. Patients with FIGO IVB AWM only had a significantly better OS than patients with FIGO IV others (P < 0.001). The numeric longer OS of patients with FIGO IVB AWM only compared with patients with FIGO IIIC was not statistically significant (P = 0.151). In multivariate analysis considering all confounding factors including residual disease, OS of patients with FIGO IIIC did not differ from patients with FIGO AWM only (hazard ratio, 0.84; 95% confidence interval, 0.56–12.26; P = 0.398).Conclusions Most AWM are acquired after preceding intervention (puncture or laparoscopy). Prognosis of patients with AWM as the only site of distant metastasis is superior compared with other stage FIGO IV patients. Therefore, up-staging of patients only because of AWM to FIGO IVB may be questioned. A revision/clarification of the FIGO classification system should be considered to avoid unnecessary stigmatization of patients and to classify these patients more appropriately according to prognosis. ER -