Clinicopathologic Studies in Patients with Ovarian Mucinous Cystadenocarcinoma

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.