Maastricht University Medical Center (MUMC), Department of Obstetrics and Gynecology.
GROW- School for Oncology and Reproduction, Maastricht.
Curr Opin Oncol. 2022 Sep 1;34(5):497-503. doi: 10.1097/CCO.0000000000000862. Epub 2022 Jul 16.
Mucinous ovarian cancers (MOCs) are categorized into infiltrative and expansile subtypes. These subtypes have different characteristics and prognoses. Patients with clinical early-stage disease of both subtypes currently undergo surgical staging (peritoneal washing, biopsies, omentectomy). Peritoneal and lymph node metastases of expansile MOC are rare, but whereas lymph node sampling (LNS) is omitted in these patients, peritoneal staging is not. Therefore, we collected all available MOC data to determine whether staging surgeries could safely be omitted in clinical early-stage expansile and infiltrative MOC.
Current literature confirms that peritoneal metastases are rare in expansile MOC: more than 90% of patients have early-stage disease. Only 3.4% of the patients with clinical early-stage expansile MOC had positive peritoneal washings at surgical staging. Patients with infiltrative MOC were diagnosed more frequently with advanced-stage disease (21-54%). Moreover, upstaging clinical early-stage infiltrative MOC based on positive cytology, peritoneum and omentum metastases occurred in 10.3% of the patients. Therefore, we recommend that patients with early-stage infiltrative MOC undergo peritoneal staging and LNS. However, in addition to omitting LNS, we can also safely recommend omitting peritoneal staging in patients with clinical early stage expansile MOC.
Peritoneal metastases are rare in clinical early-stage expansile MOC and peritoneal staging can therefore safely be omitted.
黏液性卵巢癌（MOC）分为浸润性和膨胀性亚型。这两种亚型具有不同的特征和预后。目前，两种亚型的临床早期疾病患者均接受手术分期（腹膜灌洗、活检、网膜切除术）。膨胀型 MOC 的腹膜和淋巴结转移罕见，但这些患者省略了淋巴结取样（LNS），而不省略腹膜分期。因此，我们收集了所有可用的 MOC 数据，以确定在临床早期膨胀型和浸润型 MOC 中是否可以安全省略分期手术。
目前的文献证实，膨胀型 MOC 的腹膜转移罕见：超过 90%的患者为早期疾病。在接受手术分期的临床早期膨胀型 MOC 患者中，仅有 3.4%的患者腹膜灌洗液阳性。浸润性 MOC 患者更常被诊断为晚期疾病（21-54%）。此外，10.3%的临床早期浸润性 MOC 患者因细胞学阳性、腹膜和网膜转移而被升级为晚期。因此，我们建议临床早期浸润性 MOC 患者进行腹膜分期和 LNS。然而，除了省略 LNS 之外，我们还可以安全地建议在临床早期膨胀性 MOC 患者中省略腹膜分期。
在临床早期膨胀型 MOC 中，腹膜转移罕见，因此可以安全省略腹膜分期。
