[1000] Stage IIIC Ovarian Cancer-A Heterogeneous Group of Patients with Different Prognosis.

Rania Bakkar, David Gershenson, Elvio Silva. MD Anderson Cancer Center, Houston, TX

Background: Patients suffering from primary ovarian serous carcinoma who present with regional lymph node metastasis without peritoneal involvement outside the pelvis are considered clinically as stage IIIC. Survival of those patients is controversial. We have studied their survival compared to patients with peritoneal involvement beyond the pelvis who are also grouped as stage IIIC. We also included patients with primary peritoneal carcinoma with lymph node metastasis in this study.
Design: Charts of patients with stage III primary ovarian or peritoneal serous carcinoma were reviewed. Patients with primary ovarian serous carcinoma were grouped into patients with lymph node metastasis without peritoneal involvement (group 1, n=13), and patients with ovarian carcinoma with peritoneal involvement beyond the pelvis in addition to lymph node metastasis (group 2, n=43). To compare, group 3 patients (n=38) were selected with similar criteria as group 2 but with negative sampled lymph nodes. Group 4 patients were those with primary peritoneal serous carcinoma with lymph node metastasis (n=13). Median follow up was 72 months (range 1 to 144 months).
Results:

Table1. Important clinical criteria and survival difference between patient groups

Group	1	2	3	4
Number of patients	13	43	38	13
Number with optimal Tumor Reduction	7 (54%)	26 (60%)	25 (66%)	4 (31%)
Number with preoperative Chemotherapy	0	2	3	0
Median RFS in months	42	9	12	16
Overall survival	62%	26%	36%	46%

Patients with primary ovarian serous carcinoma with regional lymph node metastasis without peritoneal involvement had better recurrence free survival (RFS) and overall survival compared to the rest of the groups (p=0.026). Survival was also better in patients with primary peritoneal serous carcinoma with lymph node metastasis than in those with primary ovarian serous carcinoma with peritoneal involvement and lymph node metastasis. There was no significant age variation and all tumors were histologically high grade. Pelvic lymph nodes were more frequently involved in peritoneal carcinoma versus aortic lymph nodes in ovarian carcinoma.
Conclusions: 1- Patients with primary ovarian serous carcinoma with lymph node metastasis without peritoneal involvement have better survival than those with peritoneal involvement.
2- Patients with primary peritoneal serous carcinoma with lymph node metastasis have better survival than those with primary ovarian serous carcinoma with peritoneal involvement and lymph node metastasis.
Based on this study, stage IIIC ovarian cancer patients need to be stratified to reflect these significant prognostic differences.
Category: Gynecologic & Obstetrics

Tuesday, March 1, 2011 1:00 PM

Poster Session IV # 100, Tuesday Afternoon