Early stage epithelial ovarian cancer metastasis through peritoneal fluid circulation

Abstract

Background Although epithelial ovarian cancer (EOC) spreads through peritoneal circulation, all patients with clinical early-stage ovarian cancer (OC) benefit from routine surgical staging is still unclear. Methods This cross-sectional study used data from medical records of patients with clinical early-stage EOC who received complete surgical staging from 2006 to 2016 at our hospital. We excluded patients with non-epithelial OC or with stage IV disease. Results Among 50 patients with clinical early-stage EOC who underwent surgical staging, biopsies showed EOC cells in peritoneal fluid for 12 patients (24%), in peritoneal tissue for ten patients (20%), and omental tissue for eight patients (16%). Of those 50 patients, 40 patients had undergone peritoneal biopsies, and the other five patients also had omental biopsies. The results showed that only one (2.5%) from 40 patients with peritoneal biopsy and three (6.7%) from 45 patients with omental biopsy had no visible nodules. From cytology examination, 3 out of 26 patients (11.5%) showed positive cytology from peritoneal washing. Conclusions Routine peritoneal biopsies do not seem advantageous for patients with clinical early-stage EOC as negative visible nodules with positive biopsy results were only 1 in 40 cases. However, further study with a larger cohort is needed to obtain more information on peritoneal fluid metastasis patterns.

Human peritoneal fluid exerts ovulation- and nonovulation-sourced oncogenic activities on transforming fallopian tube epithelial cells

“…According to the precursor escape theory [ 29 , 30 ], benign early serous proliferation (ESP) and the later tubal intraepithelial lesion cells may escape from tubal precursor lesions and transform within the peritoneal cavity [ 17 , 29 , 31 ]. A recent study of 50 patients with early-stage EOC revealed the presence of cancer cells in the peritoneal fluid in 12 (24%) patients, and micrometastases in the peritoneum and omentum in another 10 (20%) and 8 (16%) patients, respectively [ 32 ]. Studies also showed that ESP and STIL/STIC may have been shed to the peritoneal cavity prior to the formation of overt HGSC [ 17 , 30 ].…”

Categorisation of peritoneal serous effusions using the International System for Reporting Serous Fluid Cytopathology—A study on gynaecological samples

“…The absence of peritoneal cytology with the surgical specimen results in an incomplete staging of the ovarian cancers. The prognostic significance of malignant cells in washings or brushings varies, depending on the primary ovarian lesion, for example in serous borderline tumour or serous papillary carcinoma 20,21 . Moreover, positive washing cytology may be associated with adnexal involvement of endometrial carcinoma 22 .…”

“…The prognostic significance of malignant cells in washings or brushings varies, depending on the primary ovarian lesion, for example in serous borderline tumour or serous papillary carcinoma. 20,21 Moreover, positive washing cytology may be associated with adnexal involvement of endometrial carcinoma. 22 The significance of positive washings remains controversial for most types of uterine carcinoma, and staging for prognosis now requires histological confirmation of serosal/adnexal involvement.…”

Imaging of Peritoneal Carcinomatosis in Advanced Ovarian Cancer: CT, MRI, Radiomic Features and Resectability Criteria

“…Spread of ovarian carcinoma to the abdominal cavity usually occurs through the peritoneal circulation [63]. In order to understand how the tumor spreads within the peritoneum, it is necessary to know its anatomy and function.…”