Recurrence Pattern In Women With Early-Stage Epithelial Ovarian Cancer In South Of Iran

Abstract

Background: Ovarian cancer is the deadliest gynecologic cancer. Approximately 30% of patients are diagnosed with early-stage of disease. We designed this study to identify recurrence patterns of early-stage epithelial ovarian cancer (EOC) and significant clinicopathologic factors that influenced disease recurrence.

Methods: This retrospective study evaluated eligible patients who underwent surgery ± adjuvant chemotherapy between 2007 and 2017. Data was collected from medical records and follow-up visits. Data analysis was performed by SPSS 22.

Results: Two hundred and eight patients met inclusion criteria. During the follow-up period, recurrence was seen in 35 patients (16.8%). Recurrence rate within the first year of following period was 40%. Serous carcinoma was the most common histologic type in recurrence group (51.4%). The most frequent stage was ΙC3 (31.4%). In multivariate analysis, the recurrence rate was significantly higher in stage ΙC3 and ⅡB than ΙA (OR=22.4, and 7.82 respectively) and lower in endometrioid Carcinoma compared to clear cell carcinoma (OR=0.13). Disease recurrence was significantly higher in patients with positive peritoneal cytology compared with negative cytology (OR=4.17). The most common site for recurrence was peritoneal dissemination and intra-pelvic peritoneal recurrence was seen in 62.8%.

Conclusions: Peritoneal dissemination, especially intrapelvic peritoneal relapse is the most common pattern of recurrence in early-stage of EOC patients, and positive peritoneal cytology for malignancy is a predictive factor for tumor recurrence. Maximum efforts for complete primary staging is necessary to identify microscopic foci of tumors lead to disease recurrence.