Histologic and Clinical Response Characteristics in Ovarian Serous Papillary Carcinomas in Women Less Than 40 Years of Age
E Boeding, K Atkins, J Lyman, J Young, K Hanley. University of Virginia, Charlottesville, VA; Emory, Atlanta, GA
Background: Without predisposing factors such as BRCA mutations and Lynch syndrome, serous ovarian carcinomas rarely occur in women <40 years old. In older patients, the 2- and 5-year survival rates are low, but the few studies of young women have shown a more favorable prognosis. It is unclear whether age is an independent prognostic factor or if the reported improved outcome is due to early stage, low-grade tumors. Many studies included borderline tumors, which skewed the outcomes. This study was designed to determine response to treatment and survival with respect to grade and stage of serous carcinomas in women < 40. Genetic predisposition was also assessed.
Design: Pathology archives, institutional data warehouse, and chart reviews yielded age at diagnosis, stage of disease, treatment and response, family and personal history of malignancies, and referrals to genetic counseling. Slides were reviewed and tumors graded. Exclusion criteria included borderline histology or ambiguous primary source. Survival data for the study group were compared to previously published studies for pre and postmenopausal women.
Results: 23 patients met inclusion criteria (age at diagnosis 18-40). Tumor stage at diagnosis was: 3 stage I, 2 stage II, 10 stage III, and 8 stage IV. 21 patients received cytoreductive surgery (optimal in 14). Tumor grades were: 7 grade 1, 13 grade 2, and 3 grade 3. 17/18 patients survived at least 2 years (5 additional women alive but still less than 2 years since diagnosis). 4/12 patients with 5- year survival data are alive.
|2 year (N= 18)||5 year (N=12)|
|S2||100% (2/2)||0% (0/1)|
|S3||88% (7/8)||43% (3/8)|
|S4||100% (5/5)||0% (0/3)|
|2 year (N=18)||5 year (N=12)|
|G1||100% (5/5)||25% (1/4)|
|G2||86% (8/9)||50% (2/4)|
|G3||100% (4/4)||25% (1/4)|