Mucinous advanced epithelial ovarian carcinoma: clinical presentation and sensitivity to platinum-paclitaxel-based chemotherapy, the GINECO experience.
BACKGROUND
Advanced mucinous epithelial ovarian carcinoma (mEOC) has been associated with a worse prognosis than the more common serous epithelial ovarian carcinomas (sEOC), but it remains unclear whether this observation reflects a more aggressive clinical presentation and/or chemoresistance.


METHODS
Data from four randomized phase III and one phase II advanced epithelial ovarian carcinoma (EOC) first-line clinical trials were retrospectively collected, yielding 1118 patients with advanced EOC (International Federation of Gynecology and Obstetrics stages IIB-IV), 85% of whom were treated with paclitaxel (Taxol)-carboplatin-based chemotherapy.


RESULTS
Based on 786 patients with sEOC and 54 (5%) with mEOC, peritoneal carcinomatosis were more limited in mEOC, which was more frequently stages IIB-IIIB (32% versus 19%, P = 0.001) and had more frequently macroscopic complete resection after initial surgery (50% of stages II-III versus 30%, P = 0.02). In contrast, visceral metastases (stage IV) were more frequent in mEOC (30% versus 15%, P = 0.004). mEOC had a lower response rate to carboplatin-paclitaxel, and shorter progression-free and overall survival rates, for both stage IV and optimally debulked stages II-III patients.


CONCLUSIONS
Advanced mEOC appears to be highly chemoresistant and complete resection of peritoneal metastases is unable to reverse its poor prognosis. New therapeutic options are needed.
Alexandre
J
J
Medical Oncology Unit, Université Paris-Descartes, Hôtel-Dieu, Paris. Electronic address: jerome.alexandre@htd.aphp.fr.
Ray-Coquard
I
I
Medical Oncology Department, Centre Léon Bérard, Lyon.
Selle
F
F
Medical Oncology Department, Hôpital Tenon, Paris.
Floquet
A
A
Medical Oncology Department, Institut Bergonié, Bordeaux.
Cottu
P
P
Medical Oncology Department, Institut Curie, Paris.
Weber
B
B
Medical Oncology Department, Centre Alexis Vautrin, Nancy.
Falandry
C
C
Medical Oncology Department, CHU Lyon Sud, Pierre-Bénite.
Lebrun
D
D
Medical Oncology Department, Centre Jean Godinot, Reims, France.
Pujade-Lauraine
E
E
Medical Oncology Unit, Université Paris-Descartes, Hôtel-Dieu, Paris.
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D018282:Cystadenocarcinoma, Mucinous / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D010984:Platinum / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D055815:Young Adult
D010984:Platinum; D017239:Paclitaxel