The influence of intraoperative tumor rupture on recurrence risk in Stage Ic epithelial ovarian cancer

Objective: To characterize the outcomes of patients with Stage Ic epithelial ovarian carcinoma, taking into consideration the criteria that were used to assign staging. We hypothesized that tumor rupture is a less ominous prognosticator in early-stage epithelial ovarian cancer than malignant washings or ovarian surface invasion. Methods: A retrospective analysis of patients diagnosed with Stage I epithelial ovarian carcinoma at the University of Minnesota between 1990 and 2005 was carried out. Information was collected about demographics, diagnosis date, stage, grade, adjuvant treatment, last contact date and status at last contact. Statistical analysis was performed using the Kaplan-Meier method and the Cox proportion hazard model. Results: One hundred and seventeen patients with Stage I epithelial ovarian cancer were identified and included in this review. Three distinct groups of patients were considered: 1) patients with Stage Ic cancers, so-assigned because of intraoperative tumor rupture only, 2) patients with Stage Ic cancers, so-assigned for any other reason(s) than rupture alone, and 3) patients with Stages Ia and Ib cancers. The recurrence risk of patients in group 1 was not significantly different from that of patients in groups 2 or 3 (p values 0.13 and 0.69, respectively), although a trend toward decreased risk of recurrence was seen in patients from group 1 compared to both other groups. Conclusions: In our cohort of patients, the risk of tumor recurrence in patients with Stage Ic epithelial ovarian cancer, so-assigned because of intraoperative rupture alone, is not significantly different from the two other groups of patients with Stage I disease.