Preoperative unveiling of mucinous ovarian cancer subtypes: Clinical and CT features Journal Article
| Authors: | Causa Andrieu, P.; Hamdan, D.; Hassanzadeh, S.; Balakrishnan, R.; Rodriguez, L.; Zheng, J.; Fernandes, M. C.; Praiss, A.; Gangai, N.; Capanu, M.; Ellenson, L. H.; Lakhman, Y.; Chi, D. S.; Hricak, H.; Horvat, N. |
| Article Title: | Preoperative unveiling of mucinous ovarian cancer subtypes: Clinical and CT features |
| Abstract: | Objectives: To compare the frequency, clinical, imaging, and survival characteristics of mucinous ovarian carcinoma (MOC) growth pattern subtypes. Background: According 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. Methods: This 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). Results: Of 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. Conclusions: Although 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. © 2025 Elsevier B.V. |
| Keywords: | adult; human tissue; aged; gene mutation; major clinical study; overall survival; histopathology; nuclear magnetic resonance imaging; follow up; ovarian neoplasms; phenotype; progression free survival; computer assisted tomography; ovary cancer; tumor volume; ca 19-9 antigen; carcinoembryonic antigen; retrospective study; body mass; radiologist; carcinoma; ca 125 antigen; lymphadenopathy; calcification; multidetector computed tomography; human; female; article; ovarian mucinous cystadenoma; ovarian epithelial |
| Journal Title: | European Journal of Radiology |
| Volume: | 187 |
| ISSN: | 0720-048X |
| Publisher: | Elsevier B.V |
| Date Published: | 2025-06-01 |
| Start Page: | 112090 |
| Language: | English |
| DOI: | 10.1016/j.ejrad.2025.112090 |
| PROVIDER: | scopus |
| PUBMED: | 40209483 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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