TY - JOUR
T1 - Surgical treatment for clinical early-stage expansile and infiltrative mucinous ovarian cancer
T2 - can staging surgeries safely be omitted?
AU - Algera, Marc D
AU - van Driel, Willemien J
AU - van de Vijver, Koen K
AU - Kruitwagen, Roy F P M
AU - Lok, Christianne A R
N1 - Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/9
Y1 - 2022/9
N2 - PURPOSE OF REVIEW: 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.RECENT FINDINGS: Current literature confirms that peritoneal metastases are rare in expansile MOC: more than 90% had 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 early-stage expansile MOC.SUMMARY: Peritoneal metastases are rare in clinical early-stage expansile MOC and peritoneal staging can therefore safely be omitted.
AB - PURPOSE OF REVIEW: 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.RECENT FINDINGS: Current literature confirms that peritoneal metastases are rare in expansile MOC: more than 90% had 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 early-stage expansile MOC.SUMMARY: Peritoneal metastases are rare in clinical early-stage expansile MOC and peritoneal staging can therefore safely be omitted.
KW - BORDERLINE TUMORS
KW - CARCINOMA
KW - INTESTINAL-TYPE
KW - PERITONEAL
KW - expansile subtype
KW - infiltrative subtype
KW - mucinous ovarian carcinoma
KW - peritoneal staging surgery
U2 - 10.1097/CCO.0000000000000862
DO - 10.1097/CCO.0000000000000862
M3 - (Systematic) Review article
C2 - 35838205
SN - 1040-8746
VL - 34
SP - 497
EP - 503
JO - Current Opinion in Oncology
JF - Current Opinion in Oncology
IS - 5
ER -