Computed tomography features of recurrent ovarian carcinoma according to time to relapse.
BACKGROUND
Although the sites of recurrent ovarian cancer are individually described in the literature, patterns of recurrent disease are poorly understood.


OBJECTIVE
To describe CT patterns of disease in recurrent ovarian cancer. To emphasize common patterns, recognise subtle and unusual sites of recurrent disease.


METHODS
We identified patients between 1981-2004 presenting with clinical recurrence or elevated CA 125 after complete primary clinical and radiological response. CT imaging at primary diagnosis, during and after treatment and at recurrence was retrospectively reviewed. Site, distribution, stage of disease and time to relapse was recorded.


RESULTS
400 patients were treated for ovarian cancer. 214(54%) achieved complete primary response. 161(75%) relapsed with complete imaging available in 67 patients. Of the 67 patients, 14 (21%) recurred within 1 year, 44 (66%) relapsed between 1-5 years. Therefore 87% of relapses occurred within 5 years following primary treatment. Five (8%) relapsed between 5-10 years and 4 (6%) relapsed after 10 years. Commonest pattern of relapse was pelvic mass in 35 (48%) patients, solitary in 15 (22%). 27 (45%) relapsed with peritoneal thickening, 27 (45%) had small or large bowel serosal disease, 22 (33%) had enlarged lymphadenopathy, 6 as sole manifestation of recurrence, 20 (30%) presented with unusual sites of recurrence: 6 splenic, 10 hepatic, 2 biliary, 3 brain and 2 muscle.


CONCLUSIONS
Our study is the first to describe common patterns of recurrence in ovarian cancer. Most frequent site is pelvis, followed by peritoneum, serosal surfaces and nodal disease. 30% presented with disease at 'unusual' sites.
Sahdev
A
A
Academic Department of Radiology and Department of Clinical Oncology, St. Bartholomew's Hospital, West Smithfield, London, UK.
Hughes
J H
JH
Barwick
T
T
Rockall
A G
AG
Gallagher
C J
CJ
Reznek
R H
RH
D000328:Adult; D003287:Contrast Media; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D003287:Contrast Media