Mucinous epithelial ovarian cancer: a separate entity requiring specific treatment.
OBJECTIVE
Invasive mucinous carcinoma of the ovary (mucinous epithelial ovarian cancer [mEOC]) is a histologic subgroup of epithelial ovarian cancer (EOC). Chemotherapy for mEOC is chosen according to guidelines established for EOC. The purpose of this study is to determine whether this is appropriate.


METHODS
Women with advanced mEOC (International Federation of Gynecology and Obstetrics stage III or IV) who underwent first-line platinum-based chemotherapy were compared with women with other histologic subtypes of EOC in a case-controlled study.


RESULTS
Eighty-one patients (27 cases, 54 controls) treated with platinum-based regimens were analyzed. The response rates for cases and controls were 26.3% (95% CI, 9.2% to 51.2%) and 64.9% (95% CI, 47.5% to 79.8%), respectively (P=.01). The odds ratio for complete or partial response to chemotherapy for mEOC was 0.19 (95% CI, 0.06 to 0.66; P=.009) compared with other histologic subtypes of EOC. Median progression-free survival was 5.7 months (95% CI, 1.9 to 9.6 months) versus 14.1 months (95% CI, 12.0 to 16.2 months; P<.001) and overall survival was 12.0 months (95% CI, 8.0 to 15.6 months) versus 36.7 months (95% CI, 25.2 to 48.2 months; P<.001) for cases and controls, respectively. The hazard ratio for progression and death was 2.94 (95% CI, 1.71 to 5.07; P<.001) and 3.08 (95% CI, 1.69 to 5.6; P<.001), respectively, for mEOC patients as compared with controls.


CONCLUSIONS
Patients with advanced mEOC have a poorer response to platinum-based first-line chemotherapy compared with patients with other histologic subtypes of EOC, and their survival is worse. Specific alternative therapeutic approaches should be sought for this group of patients, perhaps involving fluorouracil-based chemotherapy.
Hess
Viviane
V
Gynecology Unit, Royal Marsden Hospital, Fulham Rd, London SW3 6JJ, UK.
A'Hern
Roger
R
Nasiri
Nazar
N
King
D Michael
DM
Blake
Peter R
PR
Barton
Desmond P J
DP
Shepherd
John H
JH
Ind
T
T
Bridges
J
J
Harrington
K
K
Kaye
Stanley B
SB
Gore
Martin E
ME
D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D017671:Platinum Compounds / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis
D000970:Antineoplastic Agents; D017671:Platinum Compounds