Behavior and Prognosis of Ovarian Cancer with Rare Metastatic Sites

Zuhdy, Mohammad; Alghandour, Reham; Hamdy, Omar; Metwally, Islam H.

doi:10.30476/mejc.2022.94344.1721

Behavior and Prognosis of Ovarian Cancer with Rare Metastatic Sites

Document Type : Original Article(s)

Authors

Mohammad Zuhdy ¹

Reham Alghandour ²

Omar Hamdy ¹

Islam H. Metwally ²

¹ Department of Surgical Oncology, Oncology Centre, Mansoura University (OCMU), Mansoura, Egypt

² Medical Oncology Unit, Oncology Centre, Mansoura University (OCMU), Mansoura, Egypt

https://doi.org/10.30476/mejc.2022.94344.1721

Abstract

Background: Ovarian cancer is the most prevalent gynecologic malignancy in Egypt. Although metastasis from ovarian cancer is common, there are still sites with rarely reported deposits as non-regional nodes, bone, and brain.
Method: We retrospectively recruited a group of patients over a 7-year period from the data system of a cancer center. All the recruited patients suffered from a rare distant metastasis from ovarian cancer. We used statistical software (SPSS) for the analysis of the study results. Continuous variables were presented as mean and standard deviation, if normally distributed, or median and range when non-normally distributed. Independent samples t-test was utilized to compare parametric data, whereas nonparametric data were compared through the use of the Mann-Whitney U test. Categorical data were compared with Pearson's Chi-square test or Fischer-Exact test when appropriate. A P-value < 0.05 was considered to be statistically significant.
Results: Nearly half of the patients already had metastasis at the time of the initial presentation, while the rest developed it during the disease course. Debulking was feasible in nearly half of the patients with long overall and progression-free survival. Tumors with non-regional nodal metastases seemed to have excellent survival.
Conclusion: We could recommend offering these patients optimal debulking and considering those with a non-regional nodal spread as having a curable disease.

Highlights

Mohammad Zuhdy (Google Scholar)

Omar Hamdy (Google Scholar)

Keywords

Ovarian neoplasms

Cytoreduction surgical procedure

Rare diseases

Lymphatic metastases

How to cite this article:

Zuhdy M, Alghandour R, Hamdy O, Metwally IH. Behavior and prognosis of ovarian cancer with rare metastatic sites. Middle East J Cancer. 2023;14(3):443- 50. doi:10.30476/mejc.2022. 94344.1721.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi: 10.3322/caac.21492. Erratum in: CA Cancer J Clin. 2020;70(4):313.
Ibrahim AS, Khaled HM, Mikhail NN, Baraka H, Kamel H. Cancer incidence in egypt: results of the national population-based cancer registry program. J Cancer Epidemiol. 2014;2014:437971. doi: 10.1155/2014/437971.
Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. Ovarian cancer in the world: epidemiology and risk factors. Int J Womens Health. 2019;11:287-99. doi: 10.2147/IJWH.S197604.
Reid BM, Permuth JB, Sellers TA. Epidemiology of ovarian cancer: a review. Cancer Biol Med. 2017;14(1):9-32. doi: 10.20892/j.issn.2095-3941.2016.0084.
Thomakos N, Diakosavvas M, Machairiotis N, Fasoulakis Z, Zarogoulidis P, Rodolakis A. Rare distant metastatic disease of ovarian and peritoneal carcinomatosis: A review of the literature. Cancers. 2019;11(8):1044. doi:10.3390/cancers11081044.
Deng K, Yang C, Tan Q, Song W, Lu M, Zhao W, et al. Sites of distant metastases and overall survival in ovarian cancer: A study of 1481 patients. Gynecol Oncol. 2018;150(3):460-5. doi:10.1016/j.ygyno.2018.06.022.
Hjerpe E, Staf C, Dahm-Kähler P, Stålberg K, Bjurberg M, Holmberg E, et al. Lymph node metastases as only qualifier for stage IV serous ovarian cancer confers longer survival than other sites of distant disease–a Swedish Gynecologic Cancer Group (SweGCG) study. Acta Oncologica. 2018;57(3):331-7. doi: 10.1080/0284186X.2017.1400691.
Metwally IH, Zuhdy M, Hassan A, Alghandour R, Megahed N. Ovarian cancer with metastatic inguinal lymphadenopathy: A case series and literature review. J Egypt Natl Canc Inst. 2017;29(2):109-14. doi:10.1016/j.jnci.2017.01.003.
Zuhdy M, Alghandour R, Abdelazeem G, Saleh GA, Saleh MM, Hamdy M, et al. Axillary nodal metastasis in ovarian cancer: a report of three cases and review of literature. J Egypt Natl Canc Inst. 2019;31(1):1-4. doi:10.1186/s43046-019-0008-x.
Hynninen J, Auranen A, Carpén O, Dean K, Seppänen M, Kemppainen J, et al. FDG PET/CT in staging of advanced epithelial ovarian cancer: frequency of supradiaphragmatic lymph node metastasis challenges the traditional pattern of disease spread. Gynecol Oncol. 2012;126(1):64-8. doi: 10.1016/j.ygyno.2012.04.023.
Hamdy O, Shokeir FA, Saleh GA, Zaki MM. Intramammary nodal metastasis from ovarian cancer: A case report. Eur J Breast Health. 2019;15(3):191. doi:10.5152/ejbh.2019.4712
Pakneshan S, Safarpour D, Tavassoli F, Jabbari B. Brain metastasis from ovarian cancer: a systematic review. J Neurooncol. 2014;119(1):1-6. doi:10.1007/s11060-014-1447-9.
Pectasides D, Pectasides M, Economopoulos T. Brain metastases from epithelial ovarian cancer: a review of the literature. Oncologist. 2006;11(3):252-60. doi: 10.1634/theoncologist.11-3-252.
Zhang M, Sun J. Bone metastasis from ovarian cancer. Saudi Med J. 2013;34(12):1270-3.
Zuhdy M, Gaballa K, Hamdy O, Alghandour R, Elmadawy MG, Laimon YN, et al. Parenchymal splenic metastasis from ovarian cancer: A report of two cases and literature review. J South Asian Feder Obst Gynae. 2019;11(4):274. doi: 10.5005/jp-journals-10006-1701.