Bouhani Malek, Schérier Stéphanie, Genestie Catherine, Devouassoux-Shisheboran Mojgan, Maulard Amandine, Zaccarini Francois, Leary Alexandra, Pautier Patricia, Morice Philippe, Gouy Sébastien
Gustave-Roussy Cancer Campus, Department of Gynecologic Surgery, Villejuif, France.
Gustave-Roussy Cancer campus, Department of Pathology, Villejuif, France.
Int J Gynecol Cancer. 2025 Apr;35(4):101641. doi: 10.1016/j.ijgc.2025.101641. Epub 2025 Jan 20.
Mucinous ovarian carcinomas account for 3% of all epithelial ovarian carcinomas and are categorized into expansile or infiltrative subtypes. Nevertheless, the prognostic impact of these subtypes in stage I disease remains unclear.
This retrospective study included patients with mucinous ovarian cancer who were referred to or treated at our institution between 1976 and 2022. Pathologic review was performed by 2 expert pathologists. Only patients with stage I disease were included in this study. Tumors were characterized as expansile or infiltrative, and oncologic features were analyzed.
A total of 80 cases met the inclusion criteria, with 36 and 44 patients having expansile and infiltrative subtypes, respectively. The disease stages were as follows: expansile subtype in 14 patients, stage IC in 22 patients, infiltrative subtype stage IA in 26 patients, and stage IC in 18 patients. The characteristics of the 2 groups of patients were comparable, except for the use of lymphadenectomy (more frequent in the infiltrative subtype: 28/44 [63%] vs 8/36 [22%] in expansile disease, p < .05). After a median follow-up of 79 months (range; 27.7-119.2), 10 (12.5%) recurrences occurred (3 expansile and 7 infiltrative). A total of 2 cases of expansile recurrence with pelvic recurrence were cured after secondary surgery and chemotherapy, and 1 patient died of the disease. A total of 5 patients with infiltrative recurrence had extra-pelvic spread and died of the disease, 1 patient was still alive with progressive disease, and the last was still alive and disease-free. A total of 2 cases of recurrence were observed after conservative surgery (1 of each subtype).
In this series, the overall and disease-free survival rates were not significantly different between patients with expansile and infiltrative stage I mucinous ovarian carcinoma. However, the prognosis of recurrent infiltrative cases is poorer than expansile cases.
黏液性卵巢癌占所有上皮性卵巢癌的3%，可分为膨胀型或浸润型亚型。然而，这些亚型对Ⅰ期疾病预后的影响仍不明确。
这项回顾性研究纳入了1976年至2022年间在我院就诊或接受治疗的黏液性卵巢癌患者。由2名专家病理学家进行病理复查。本研究仅纳入Ⅰ期疾病患者。肿瘤被分为膨胀型或浸润型，并分析肿瘤学特征。
共有80例符合纳入标准，其中分别有36例和44例患者为膨胀型和浸润型亚型。疾病分期如下：膨胀型亚型14例为ⅠA期，22例为ⅠC期；浸润型亚型26例为ⅠA期，18例为ⅠC期。两组患者的特征具有可比性，但淋巴结清扫的使用情况除外（浸润型亚型更常见：浸润型疾病中为28/44 [63%]，膨胀型疾病中为8/36 [22%]，p < 0.05）。中位随访79个月（范围：27.7 - 119.2个月）后，发生了10例（12.5%）复发（3例膨胀型和7例浸润型）。共有2例膨胀型复发伴盆腔复发的患者在二次手术和化疗后治愈，1例患者死于该疾病。共有5例浸润型复发患者出现盆腔外扩散并死于该疾病，1例患者疾病进展但仍存活，最后1例患者仍存活且无疾病。保守手术后观察到2例复发（各亚型1例）。
在本系列研究中，Ⅰ期膨胀型和浸润型黏液性卵巢癌患者的总生存率和无病生存率无显著差异。然而，浸润型复发病例的预后比膨胀型病例差。
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