title: [Ovarian carcinoma presents as distant metastases without detectable tumors of the origin disease at the first presentation].
abstract: OBJECTIVE
  To study the characteristics, therapies and prognosis of the patients with epithelial ovarian cancer (EOC) that are initially categorized as extra-abdominal adenocarcinoma of unknown primary.
  
  
  METHODS
  Twenty-five patients with EOC, who were treated in the Cancer Hospital of Fudan University from Jan. 1986 to Dec. 1997, and manifesting as extra-peritoneal or liver parenchyma metastases at the time of presentation, without detectable ovarian tumors, were retrospectively studied.
  
  
  RESULTS
  Supraclavicular and inguinal lymph node metastases were common in this group of patients, with 6 and 5 cases respectively, and 6 patients with more than two sites metastases simultaneously. 16 patients (64%) were optimally surgical debulked. 20 patients with stage IV EOC initially presenting as extra-abdominal metastases experienced a better prognosis, with an estimated median survival of 24 months. Of whom the median survival was 30 months in patients presenting with pleural effusion or supraclavicular lymph node metastases Vs. 19 months in those with other sites spread (P = 0.0264).
  
  
  CONCLUSIONS
  The prognosis of such cases, particularly for those with supraclavicular lymphadenopathy or malignant pleural effusion, is a lot better than other stage IV EOC patients, probably because of most of the patients initially presenting with distant metastases being generally in a good condition competent for aggressive surgery or multi-cycle chemotherapy.
authors.affiliation: Department of Gynecological Oncology, Cancer Hospital, Fudan University, Shanghai 200032, China.
authors.forename: R
authors.initials: R
authors.lastname: Zang
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.forename: S
authors.initials: S
authors.lastname: Cai
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D016019:Survival Analysis