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Outcomes of patients with early stage mucinous ovarian carcinoma : a Dutch population-based cohort study comparing expansile and infiltrative subtypes

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Abstract
Objective This study aimed to assess the outcomes of patients with early stage mucinous ovarian carcinoma based on subtype (expansile vs infiltrative). Methods We retrospectively analyzed all surgically treated patients with mucinous ovarian carcinoma in the Netherlands (2015-2020), using data from national registries. Subtypes were determined, with any ambiguities resolved by a dedicated gynecologic pathologist. Patients with International Federation of Gynecology and Obstetrics (FIGO) stage I were categorized into full staging, fertility-sparing, or partial stagings. Outcomes were overall survival and recurrence free survival, and recurrence rates. Results Among 409 identified patients, 257 (63%) had expansile and 152 (37%) had infiltrative tumors. Patients with expansile tumors had FIGO stage I more frequently (n=243, 95% vs n=116, 76%, p<0.001). For FIGO stage I disease, patients with expansile and infiltrative tumors underwent similar proportions of partial (n=165, 68% vs n=78, 67%), full (n=32, 13% vs n=23, 20%), and fertility-sparing stagings (n=46, 19% vs n=15, 13%) (p=0.139). Patients with expansile FIGO stage I received less adjuvant chemotherapy (n=11, 5% vs n=24, 21%, p<0.001), exhibited better overall and recurrence free survival (p=0.006, p=0.012), and fewer recurrences (n=13, 5% vs n=16, 14%, p=0.011). Survival and recurrence rates were similar across the expansile extent of staging groups. Patients undergoing fertility-sparing staging for infiltrative tumors had more recurrences compared with full or partial stagings, while recurrence free survival was similar across these groups. Full staging correlated with better overall survival in infiltrative FIGO stage I (p=0.022). Conclusions While most patients with FIGO stage I underwent partial staging, those with expansile had better outcomes than those with infiltrative tumors. Full staging was associated with improved overall survival in infiltrative, but not in expansile FIGO stage I. These results provide insight for tailored surgical approaches.
Keywords
Obstetrics and Gynecology, Oncology, surgery, cystadenocarcinoma, mucinous, ovarian cancer, INTESTINAL-TYPE, BORDERLINE TUMORS, CANCER, NETHERLANDS

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MLA
Algera, Marc Daniël, et al. “Outcomes of Patients with Early Stage Mucinous Ovarian Carcinoma : A Dutch Population-Based Cohort Study Comparing Expansile and Infiltrative Subtypes.” INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, vol. 34, no. 5, 2024, pp. 722–29, doi:10.1136/ijgc-2023-004955.
APA
Algera, M. D., Van de Vijver, K., van Driel, W. J., Slangen, B. F. M., Lof, F. C., van der Aa, M., … Lok, C. A. R. (2024). Outcomes of patients with early stage mucinous ovarian carcinoma : a Dutch population-based cohort study comparing expansile and infiltrative subtypes. INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, 34(5), 722–729. https://doi.org/10.1136/ijgc-2023-004955
Chicago author-date
Algera, Marc Daniël, Koen Van de Vijver, Willemien J van Driel, Brigitte F M Slangen, Fabienne C Lof, Maaike van der Aa, R F P M Kruitwagen, and Christianne A R Lok. 2024. “Outcomes of Patients with Early Stage Mucinous Ovarian Carcinoma : A Dutch Population-Based Cohort Study Comparing Expansile and Infiltrative Subtypes.” INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 34 (5): 722–29. https://doi.org/10.1136/ijgc-2023-004955.
Chicago author-date (all authors)
Algera, Marc Daniël, Koen Van de Vijver, Willemien J van Driel, Brigitte F M Slangen, Fabienne C Lof, Maaike van der Aa, R F P M Kruitwagen, and Christianne A R Lok. 2024. “Outcomes of Patients with Early Stage Mucinous Ovarian Carcinoma : A Dutch Population-Based Cohort Study Comparing Expansile and Infiltrative Subtypes.” INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 34 (5): 722–729. doi:10.1136/ijgc-2023-004955.
Vancouver
1.
Algera MD, Van de Vijver K, van Driel WJ, Slangen BFM, Lof FC, van der Aa M, et al. Outcomes of patients with early stage mucinous ovarian carcinoma : a Dutch population-based cohort study comparing expansile and infiltrative subtypes. INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER. 2024;34(5):722–9.
IEEE
[1]
M. D. Algera et al., “Outcomes of patients with early stage mucinous ovarian carcinoma : a Dutch population-based cohort study comparing expansile and infiltrative subtypes,” INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, vol. 34, no. 5, pp. 722–729, 2024.
@article{01HSJTTNFACX5Y6FJ5DHCBCAZQ,
  abstract     = {{Objective This study aimed to assess the outcomes of patients with early stage mucinous ovarian carcinoma based on subtype (expansile vs infiltrative). Methods We retrospectively analyzed all surgically treated patients with mucinous ovarian carcinoma in the Netherlands (2015-2020), using data from national registries. Subtypes were determined, with any ambiguities resolved by a dedicated gynecologic pathologist. Patients with International Federation of Gynecology and Obstetrics (FIGO) stage I were categorized into full staging, fertility-sparing, or partial stagings. Outcomes were overall survival and recurrence free survival, and recurrence rates. Results Among 409 identified patients, 257 (63%) had expansile and 152 (37%) had infiltrative tumors. Patients with expansile tumors had FIGO stage I more frequently (n=243, 95% vs n=116, 76%, p<0.001). For FIGO stage I disease, patients with expansile and infiltrative tumors underwent similar proportions of partial (n=165, 68% vs n=78, 67%), full (n=32, 13% vs n=23, 20%), and fertility-sparing stagings (n=46, 19% vs n=15, 13%) (p=0.139). Patients with expansile FIGO stage I received less adjuvant chemotherapy (n=11, 5% vs n=24, 21%, p<0.001), exhibited better overall and recurrence free survival (p=0.006, p=0.012), and fewer recurrences (n=13, 5% vs n=16, 14%, p=0.011). Survival and recurrence rates were similar across the expansile extent of staging groups. Patients undergoing fertility-sparing staging for infiltrative tumors had more recurrences compared with full or partial stagings, while recurrence free survival was similar across these groups. Full staging correlated with better overall survival in infiltrative FIGO stage I (p=0.022). Conclusions While most patients with FIGO stage I underwent partial staging, those with expansile had better outcomes than those with infiltrative tumors. Full staging was associated with improved overall survival in infiltrative, but not in expansile FIGO stage I. These results provide insight for tailored surgical approaches.}},
  author       = {{Algera, Marc Daniël and Van de Vijver, Koen and van Driel, Willemien J and Slangen, Brigitte F M and Lof, Fabienne C and van der Aa, Maaike and Kruitwagen, R F P M and Lok, Christianne A R}},
  issn         = {{1048-891X}},
  journal      = {{INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER}},
  keywords     = {{Obstetrics and Gynecology,Oncology,surgery,cystadenocarcinoma, mucinous,ovarian cancer,INTESTINAL-TYPE,BORDERLINE TUMORS,CANCER,NETHERLANDS}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{722--729}},
  title        = {{Outcomes of patients with early stage mucinous ovarian carcinoma : a Dutch population-based cohort study comparing expansile and infiltrative subtypes}},
  url          = {{http://doi.org/10.1136/ijgc-2023-004955}},
  volume       = {{34}},
  year         = {{2024}},
}

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