Abstract
BackgroundAlthough epithelial ovarian cancer (EOC) spreads through peritoneal circulation, all patients with clinical early-stage ovarian cancer (OC) benefit from routine surgical staging is still unclear.MethodsThis cross-sectional study used data from medical records of patients with clinical early-stage EOC who received complete surgical staging from 2006 to 2016 at our hospital. We excluded patients with non-epithelial OC or with stage IV disease.ResultsAmong 50 patients with clinical early-stage EOC who underwent surgical staging, biopsies showed EOC cells in peritoneal fluid for 12 patients (24%), in peritoneal tissue for ten patients (20%), and omental tissue for eight patients (16%). Of those 50 patients, 40 patients had undergone peritoneal biopsies, and the other five patients also had omental biopsies. The results showed that only one (2.5%) from 40 patients with peritoneal biopsy and three (6.7%) from 45 patients with omental biopsy had no visible nodules. From cytology examination, 3 out of 26 patients (11.5%) showed positive cytology from peritoneal washing.ConclusionsRoutine peritoneal biopsies do not seem advantageous for patients with clinical early-stage EOC as negative visible nodules with positive biopsy results were only 1 in 40 cases. However, further study with a larger cohort is needed to obtain more information on peritoneal fluid metastasis patterns.
Highlights
Among gynecologic cancers, ovarian cancer (OC) causes major death in women
Routine peritoneal biopsies do not seem advantageous for patients with clinical early-stage epithelial ovarian cancer (EOC) as negative visible nodules with positive biopsy results were only 1 in 40 cases
About 70% of new OC cases are diagnosed at an advanced stage [3, 4], and 90% are epithelial ovarian cancer (EOC), whereas the remainder is non-epithelial [4,5,6]
Summary
Ovarian cancer (OC) causes major death in women. In 2018, an estimated 22,240 new OC diagnoses and 14,070 deaths from OC occurred in the United States [1,2,3]. About 70% of new OC cases are diagnosed at an advanced stage [3, 4], and 90% are epithelial ovarian cancer (EOC), whereas the remainder is non-epithelial [4,5,6]. About 50% of the OCs were diagnosed at an advanced stage. Advanced-stage OC has a worse prognosis than early-stage OC [4, 6]. Epithelial ovarian cancer (EOC) spreads through peritoneal circulation, all patients with clinical early-stage ovarian cancer (OC) benefit from routine surgical staging is still unclear
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