The impact of peritoneal metastases in epithelial ovarian cancer with positive nodes

Objective: The objective of the study was to evaluate the impact of the extent of intraperitoneal disease, presurgical and postsurgical debulking, in patients with epithelial ovarian cancer (EOC) stages IIIC and IV with nodal metastases. Methods: This was a retrospective chart review of 101 patients with EOC treated at the Mayo Clinic between 1996 and 2000. All patients had positive retroperitoneal lymph nodes (stages IIIC and IV). Patients were divided into complete or incomplete debulking, according to no visible or visible residual disease after debulking. Patients with incomplete debulking were subclassifed into residual disease less than 0.5, 0.6 to 1, 1.1 to 1.5, 1.6 to 2, and more than 2 cm. All patients received adjuvant chemotherapy with platinum-based regimen. Results: The mean patient's age was 61.8 years. The mean length of follow-up was 3.5 years. The 5-year overall survival rates were 52.9% and 38.7% for International Federation of Gynecology and Obstetrics stages IIIC and IV, respectively. Significant prognostic factors were the presence of peritoneal metastases before debulking (P = 0.01), the presence of visible residual tumor after debulking, (P = 0.007), and International Federation of Gynecology and Obstetrics stage (P = 0.049). Conclusion: The extent of peritoneal metastases before debulking is a significant factor for survival in patients with node-positive EOC.