title: [Umbilicus metastasis in patients with epithelial ovarian cancer : clinical features of 21 patients].
abstract: OBJECTIVE
  To analyze the clinical features, treatments and prognosis of patients with Sister Mary Joseph's nodule of umbilicus (SMJN) from epithelial ovarian cancer (EOC) patients.
  
  
  METHODS
  Among a total of 2642 pathologically diagnosed EOC cases, 21 cases with SMJN were histopathologically diagnosed and had an age range of 40-66 years at Sun Yat-sen University Cancer Center between January 1991 and January 2011. Their clinical data were retrospectively analyzed.
  
  
  RESULTS
  The incidence of SMJN in EOC was 0.79 %. The 1, 2 and 5-year survival rates were 61.8%, 26.8% and 9.5% respectively. The diagnosis was confirmed via local excision biopsy, fine-needle aspiration biopsy or gross pathological diagnosis. Univariate analysis showed that patients with progressive disease or relapsing with umbilical metastasis after treatment had worse prognosis than those diagnosed at pre-treatment (22 vs 6 months, P < 0.01) . Patients with suboptimal cytoreductive surgery and/or less than 6 circles of chemotherapy or palliative treatment had worse prognosis than those with optional cytoreductive surgery during 6-8 circles of chemotherapy (21 vs. 4 months). Multivariate analysis showed that the time to diagnose and treatment regimen were independent predictors of survival (relative risk = 41.28, P < 0.01).
  
  
  CONCLUSIONS
  SMJN is a rare manifestation of EOC. Improving the diagnostic vigilance, optimal debulking surgery plus regular chemotherapy and other new individualized postoperative treatments may arrest the progression of EOC and prolong patient survival.
authors.affiliation: Department of Gynecology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Xiao
authors.forename: Jun-dong
authors.initials: JD
authors.lastname: Li
authors.forename: Man-man
authors.initials: MM
authors.lastname: Xu
authors.forename: An-na
authors.initials: AN
authors.lastname: Zhu
authors.forename: Yan-lin
authors.initials: YL
authors.lastname: Feng
mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D014472:Umbilicus / Q000473:pathology*