Impact of abdominal wall metastases on prognosis in FIGO IV epithelial ovarian cancer Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Saturday, October 22, 2016

Impact of abdominal wall metastases on prognosis in FIGO IV epithelial ovarian cancer


Objective: Epithelial ovarian cancer (EOC) patients with the presence of abdominal wall metastasis (AWM) are categorized as stage FIGO IVB, irrespective of other biologic factors. 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 – 2014 were included. Patients were categorized as: FIGO IIIC (n = 308), FIGO IVB-only-AWM (n = 86), and FIGO IV-others (metastases other than AWM, n = 240). Clinico-pathological 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: The median OS in patients with stage FIGO IIIC, FIGO IVB-only-AWM, and FIGO IV-others was 37, 58, and 25 months (p < 0.001), respectively. Patients with FIGO IVB-only-AWM had a significantly better overall survival than patients with FIGO IV-others (p < 0.001). In multivariate analysis, OS of patients with FIGO IIIC did not differ to patients with FIGO IVB-only-AWM (HR 0.84, 95% CI 0.56 – 12.26, p = 0.398).

Conclusion: 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 better these patients more appropriately with respect to their prognosis.


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