Keywords:
Oncology, Molecular imaging, Computer applications, CT, MR, PET-CT, Computer Applications-Teleradiology, Efficacy studies, Structured reporting, Metastases, Outcomes, Multidisciplinary cancer care
Authors:
M. SHARMA1, O. Bohnsack2, D. Clark2, N. Rohra1; 1HYDERABAD/IN, 2Berlin/DE
DOI:
10.26044/ecr2019/C-2951
Aims and objectives
Metastasis is the leading cause of ovarian cancer (OC) related death with more than 70% of OC patients diagnosed with metastasis with five-year survival rates below 45%.
The highest age-adjusted incidence rates are observed in developed parts of the world,
including North America and Central and Eastern Europe,
with rates generally exceeding 8 per 100,000.
Rates are intermediate in South America (5.8 per 100,000),
and lowest in Asia and Africa [1].
OC has a unique pattern of metastasis where the hematogenous spread is less common.
OC cells mainly metastasize within the peritoneal cavity at presentation and throughout the course of the disease in 85% of the patients which involves exfoliation from the primary tumor,
followed by survival and transport in the peritoneal fluid and finally metastatic colonization of the organs within the peritoneal cavity [2-3].
In developed countries,
more than 90% of malignant ovarian tumors are epithelial in origin,
5%–6% of tumors constitute sex cord-stromal tumors (e.g.,
granulose cell tumors,
thecomas,
etc.) and 2%–3% are germ cell tumors (e.g.,
teratomas,
dysgerminomas,
etc.) [1].
Although,
intraperitoneal route is the most common route of OC metastasis,
it can also spread through lymphatic and hematogenous route [2].
There is a tendency of conventional imaging to under estimate the frequency of peritoneal spread.
Distant metastasis at the time of diagnosis or evolution of disease can lead to devastating effect and poor survival rate.
Late diagnosis and diffuse symptoms are the major reasons for poor prognosis of OC [3].
Useful endpoints in clinical trials are tumour shrinkage (objective response) and disease progression.
Since publication of RECIST guidelines,
these criteria are used in the assessment of treatment outcomes.
Number of issues and queries have led to the development of a revised RECIST guideline (version 1.1) [4-5].
The purpose of the study was to obtain the frequency of organ involvement in OC metastasis and identify the most common route of OC metastasis.