Ovarian carcinoma: A review of 200 primary and 51 secondary cases

Abstract

1.1. Two hundred cases of primary carcinoma of the ovary with at least fiveyear follow-up are presented. The papillary serous cystadenocarcinomas make up almost two-thirds of the total series.2.2. The five-year over-all survival rates are 30.8 per cent absolute and 27.5 per cent relative.3.3. The so-called borderline papillary serous cystadenocarcinoma is a malignant tumor.4.4. Prognosis depends chiefly upon the histogenetic type of tumor and upon the histological degree of malignancy, both of which largely control the clinical extent of disease. Ovarian tumors of low-grade histological malignancy have the most favorable prognosis. Similarly, tumors still confined to the adnexa are most favorable to treat. Clinical extent of disease is usually greater in tumors of high-grade histological malignancy.5.5. The following tumors are regarded as being of low-grade histological malignancy; papillary serous cystadenocarcinoma, borderline and Grade I; most papillary pseudomucinous cystadenocarcinomas; and most granulosa cell tumors. The best chances for survival occur in these cases.6.6. Complete surgical removal of the internal genitals remains the treatment of choice in ovarian carcinoma. Conservative surgery is rarely justifiable.7.7. Radiation therapy has a definite place in the treatment of certain cases of ovarian carcinoma chiefly to prolong survival time and perhaps occasionally (although rarely) to cure residual disease. It should be administered to all patients with tumors of high-grade histological malignancy even if localized to one or both ovaries. It seems of no value in tumors of low-grade histological malignancy unless there is operative evidence of spread beyond the ovaries; in the latter event, x-ray should be given. It should be given to all patients with extension of tumor beyond the ovaries regardless of the amount of spread and regardless of histological type.