ArticleEuropean journal of radiology2025
Preoperative unveiling of mucinous ovarian cancer subtypes: Clinical and CT features.
Article in European journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo compare the frequency, clinical, imaging, and survival characteristics of mucinous ovarian carcinoma (MOC) growth pattern subtypes.
backgroundAccording to ESGO 2024 guidelines, fertility-sparing surgery can be considered for stages IA and IC1 expansile MOC due to their excellent prognoses and low recurrence risk. The ability to diagnose MOC subtypes preoperatively would aid treatment planning. However, variables for preoperatively distinguishing MOC subtypes have not been established.
methodsThis IRB-approved, retrospective, single-center study included consecutive patients (≥18 years) with pre-treatment CT from 01/2000-12/2020 and pathological diagnosis of MOC. One experienced radiologist interpreted all CTs, reviewing challenging cases with a senior radiologist. Clinical (age, CA-125, FIGO stage), outcome (local recurrence, distant metastasis, death from cancer/unrelated cause), and CT (laterality, size, mass type, calcifications, adenopathy, peritoneal/serosal implants, ascites) were compared (p < 0.05).
resultsOf 24 patients with MOC, 50 % (n = 12) had expansile disease. Compared to infiltrative MOC, expansile MOC appeared more often at stage I (92 % vs. 58 %), at younger ages (median, 45 vs. 68 years; p = 0.03), and with lower CA-125 (median, 18 vs. 78 ng/mL). At CT, 75 % of expansile vs. 58 % of infiltrative cases were multilocular masses with solid components and ill-defined borders; 25 % of infiltrative, but no expansile cases, were bilateral; 25 % of patients with infiltrative but none with expansile MOC experienced early recurrence, eventually dying of cancer. P-values were > 0.10 for all differences but age, potentially due to the small sample.
conclusionsAlthough CT features of MOC subtypes were similar, expansile MOC presented in younger patients with lower CA-125 levels, was more often diagnosed at stage I, and was uniformly unilateral.
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