abstract:
Patterns and Prognostic Importance of Hepatic Involvement in Patients with Serous Ovarian Cancer: A Single-Institution Experience with 244 Patients | Radiology
To
evaluate the frequency, patterns, and prognostic importance of
metastatic hepatic involvement in serous ovarian
cancer.
This
institutional review board-approved retrospective study, with waived
informed consent, included 244 patients with
pathologically proven serous ovarian cancer
(mean age ± standard deviation, 59 years ± 10.7;
range 19–93 years). Electronic medical records and all available
imaging studies over a median follow-up of 44 months
(interquartile range [IQR], 27–70) were reviewed
to identify the frequency of liver parenchymal
invasion (LPI) from perihepatic peritoneal metastasis and
hematogenous liver metastases. The associations and prognostic
importance of LPI and hematogenous metastases
were studied by using univariate and
multivariate Cox proportional analysis.
Eighty-four
of 244 patients (34%) developed perihepatic metastases, of whom
55 (23%) developed LPI after median of 43 months (IQR,
25–63). Hematogenous hepatic metastases
developed in 38 of 244 patients (16%) after
median of 42 months (IQR, 26–64). At multivariate analysis, age
(
P = .008; hazard ratio [HR]: 1.03; 95%
confidence interval [CI]: 1.009, 1.07) and
suboptimal cytoreduction (
P = .03; HR, 2.13; 95% CI: 1.12, 4.07) were associated with LPI. Increasing age (
P = .01; HR, 1.04; 95% CI: 1.008, 1.08), high-grade tumor (
P = .01; HR, 6.75; 95% CI: 1.44, 120.5), and advanced stage (
P
= .03; HR, 3.16; 95% CI: 1.94, 4.56) were
associated with hematogenous metastases. Overall
survival with and without LPI was similar (median, 80 months; IQR,
50–not reached vs 123 months; IQR, 49–279;
P
= .6). Hematogenous metastases were associated
with significantly shorter survival at
univariate (median 63 months, IQR 43–139 vs 145
months, IQR 50–not reached;
P = .006) and multivariate analyses (
P = .03; HR, 1.88; 95% CI: 1.14, 3.28).
Differentiating
hematogenous metastases and LPI is important for
radiologists; hematogenous metastases are associated with shorter
survival, while LPI does not adversely affect
survival and prognostically behaves like
peritoneal disease.
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