Extra-abdominal metastases from epithelial ovarian carcinoma: an analysis of 20 cases.

Objective: To investigate the clinicopathologic risk factors associated with extra-abdominal metastases in epithelial ovarian carcinoma patients and to determine prognostic factors associated with survival.

Methods: A retrospective chart review was conducted on 20 cases of epithelial ovarian carcinoma patients with extra-abdominal metastases and 645 cases of epithelial ovarian carcinoma patients without extra-abdominal metastases treated at our unit between 1993 and 2007.

Results: A total of 25 extra-abdominal metastatic sites were diagnosed in 20 patients. Sites of metastases were lung, n = 7; skin, n = 6; pleura, n = 5; brain, n = 3; mediastinal lymph node, n = 3; and bone, n = 1. Median interval time between diagnosis of epithelial ovarian carcinoma and documentation of metastatic disease of these 18 patients was 16 months. Median survival time after extra-abdominal metastases was 11 months. In a univariate analysis, Karnofsky performance status (KPS), clinical stage, and sensitivity of primary chemotherapy were the risk factors significantly associated with extra-abdominal metastases. These risk factors remained significant in multivariate analysis. In univariate analysis KPS, sensitivity of primary chemotherapy, metastatic site, and systemic therapy after diagnosis of extra-abdominal metastases were the factors significantly associated with survival.

Conclusion: Some clinicopathologic risk factors may associate with extra-abdominal metastases. Prognosis after documentation of extra-abdominal metastases from epithelial ovarian carcinoma is poor. The important prognostic factors associated with survival are KPS, sensitivity of primary chemotherapy, metastatic site, and systemic therapy after diagnosis of extra-abdominal metastases.