title: Occult metastasis in early ovarian cancers: risk factors and associated prognosis.
abstract: OBJECTIVE
  The purpose of this study was to define risk factors associated with the occult metastasis in early stage epithelial ovarian carcinoma (EOC), and to compare the survivals in respect to occult metastasis.
  
  
  METHODS
  A retrospective review of 169 patients with clinically early stage EOC was performed.
  
  
  RESULTS
  Overall, 53 patients (53/169, 31.4%) were upstaged. The most common occult metastasis was the lymphatic involvement (22/53; 41.5%). Overall, 64.1% (34/53) of these upstaged patients had unrecognized disease in the upper abdomen or retroperitoneal space. Multivariable analysis revealed 3 factors to be associated with occult metastasis: Ca-125 levels > or = 500 U/mL (P = .04), positive peritoneal cytology (P = .001), and grade III disease (P = .04). Five-year survival rates were 61.83% and 88.25%, respectively, in patients with or without occult metastasis. Among the upstaged patients, omental or peritoneal metastasis revealed the worst prognosis.
  
  
  CONCLUSIONS
  Proper surgical staging is an important issue in early stage ovarian cancers, particularly in patients with high Ca-125 levels, positive cytology, and high grade tumor.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Ayhan
authors.forename: Murat
authors.initials: M
authors.lastname: Gultekin
authors.forename: Nilufer Yigit
authors.initials: NY
authors.lastname: Celik
authors.forename: Polat
authors.initials: P
authors.lastname: Dursun
authors.forename: Cagatay
authors.initials: C
authors.lastname: Taskiran
authors.forename: Guldeniz
authors.initials: G
authors.lastname: Aksan
authors.forename: Kunter
authors.initials: K
authors.lastname: Yuce
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000556:secondary*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010051:Ovarian Neoplasms / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors