Outcome of Ovarian Cancer Patients Who Underwent Incomplete Surgical Staging
Pacharawalee Panprom MD*, Ruangsak Lertkhachonsuk MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok
Objective : To determine outcomes of patients with early stage epithelial ovarian cancer (EOC) who underwent
incomplete surgical staging with those who had complete surgical staging.
Material and Method: Retrospective chart reviews were performed on early EOC (FIGO Stage I-II) patients
who had registered in the Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital
between 1994 and 2003. Two groups of patients were identified, patients who underwent incomplete surgical
staging (n = 51) and those who had complete surgical staging (n = 50). Recurrence rate and disease free
interval were demonstrated. The 5 years survival was estimated using Kaplan-Meire method.
Results : Between 1994 and 2003, 101patients presented with early EOC. The median age at presentation was
48 years (range, 24-86). Histology distribution showed clear cell carcinoma in 35 cases (34.7%), mucinous
carcinoma in 25 cases (24.8%), endometrioid carcinoma in 22 cases (21.8%), mixed epithelial cancer in 10
cases (9.9%), and serous carcinoma in nine cases (8.9%). Fifty-one cases (50.5%) underwent incomplete
surgical staging initially. Recurrent rate in the incomplete surgical staging group was 11.8% compared with
14% in complete surgical staging group (p = 0.257). At the median follow up of 60 months, 50.5% of patients
survived. The 5 years survival rate of incomplete surgical staged was 82.4% and 94.6%, in complete surgical
staged (p = 0.404), when focused in the subgroup analysis, incomplete staging group with histology grade 3
compared to complete staging group. They had overall 5 years survival rate 81.1% vs. 88.4% (p = 0.037).
Patients with stage II who underwent incomplete staging or complete staging had an overall survival rate
63% vs. 92.3% ( p = 0.012).
Conclusion : In King Chulalongkorn Memorial Hospital, overall outcome of patients with early stage epithelial
ovarian cancer who had incomplete staging was no different from patients who had complete staging. However,
patients who had incomplete staging with grade 3 or stage II tended to have less recurrent rate and survival
time.
Keywords : Early epithelial ovarian cancer, Incomplete surgical staging, Complete surgical staging
