Nongenital metastatic cancers of the ovary: A clinical analysis

Objectives: The aim of this study was to outline the parameters affecting the extent and type of surgery for metastatic tumors of the ovary. Material-method: The data of 34 operated patients diagnosed with metastatic tumors of the ovary at the Istanbul University, Medical Faculty Gynecologic Oncology Department between 1991 and 1999 were evaluated retrospectively. The patients were divided into two study groups according to the origin of the tumor: 1. Metastatic tumors of the ovary originating from the organs apart from the gastrointestinal system (MT-NonGIS), 2. Metastatic tumors of the ovary originating from the gastrointestinal system (MT-GIS). Survival rates were calculated in months from the time of ovarian surgical intervention to the date of last known data of patient status. Mean survival rates for the noncensored data were calculated by the Kaplan-Meier method and resulting curves were compared by the log-rank procedure. Statistical significance was determined at the level of 0.05. Results: The survival rate for all cases was 24.21 months; the same rate was calculated to be 45.36 months for the MT-nonGIS group while it was 15.8 months for the MT-GIS group. When both groups were compared in terms of survival rates, the difference was significant (p: 0.0025, log rank: 9.14). Overall cumulative survival rates for 9, 14, 24 and 50 months were 61.59%, 50.05%, 41.7% and 11.58%, respectively. It was also found that surgery performed on patients in the MT-GIS group did not alter the survival rate but if peritoneal metastasis was observed during surgery, life expectancy for these cases was significantly less. Conclusion: Although the number of patients included in our study was small, it is important because it gives us a clue about the type of surgery that should be performed in GIS-originating metastatic tumors of the ovary. Our study shows that aggressive surgery should be avoided in patients with peritoneal metastasis/spread.