MULTICENTRICITY IN OVARIAN SEROUS TUMORS-Part 3

Paper rejected by IJGC-2023

Part 3- Additional evidence.

1-Stage of the disease does not correlate with the tumor size. In general, the size of the tumor has a good correlation with the stage of the disease. The general rule, for most neoplasms, is that smaller tumors have a better chance to be found at low stage and vice versa. In ovarian serous tumors this is not the case.

Table 1- Mean size of Serous Borderline Tumor and High-Grade Serous Carcinoma.

Stage I Stage III

Serous Borderline 14 cm 6 cm p=0.0037

High grade serous Ca 9.5 cm 7.5 cm p=043

There were 11 stage I high-grade serous Cas, but only 4 cases survived longer than 10 years. Three of these 4 cases measured more than 20 cm. It is possible that only these 4 cases were true stage I cases. These 4 cases were cystic with papillae inside the cyst. Stage I ovarian serous tumors might represent a specific type of tumor, rather than a neoplasm found early.

2-Survival of the patients does not correlate with the grade of the carcinoma or with the stage of the disease. In most neoplasms there is a very good correlation between the grade of the tumor and the overall survival, and between the stage of the disease and survival.

The 3 yr, 5 yr, and 10 yr overall survival for 105 cases of HGSCa was: 78%, 63%, and 24.3%.

The 3 yr, 5 yr, and 10yr overall survival for 118 cases of LGSCa was: 81 %, 59.3%, and 20.9%. (p=0.305)

Survival related to stage was calculated only in the HGSCa because of the low number of LGSCa cases found at low stage. In the HGSCa stage I, 63% died of disease, in stage II 70%, and in stage III 78%.

3-Lack of correlation in the histologic features between the primary tumor and the “metastases” in some cases. In most neoplasms the histologic appearance of all the metastases is similar to the primary tumor, or it could be less differentiated. In 6 of the 80 stage III HGSCa cases the metastases had a different histologic appearance. See images below.

Patient 1A-Ovarian tumor

Patient 1B-Omental tumor

Patient 2A-Ovarian tumor

Patient 2B-Omental tumor