The surgical staging of apparent early-staged ovarian mucinous carcinoma

Objectives: The study aimed to explore the rate of upstaging after complete surgical staging in patients with apparent FIGO stage I ovarian mucinous carcinoma. Methods: Ovarian mucinous carcinoma patients with surgical treatment were, retrospectively, reviewed in Peking Union Medical College Hospital between October 2020 and January 1994. Results: Totally, 163 patients were included in this study, Surgical re-staging was performed in 89 patients after initial incomplete surgical staging and one-step complete surgical staging was performed in 74 patients. For these initial incompletely staged patients, residual tumors were found in 16 patients (16/89, 17.9%); for 19 patients with apparent FIGO stage IA, no patient was found to have residual tumor after incomplete staging surgery confirmed by the final pathology result of re-staging surgery. Ovarian cystectomy (HR=4.932, 95% CI= 1.347-18.058, P=0.016) were independent risk factors for residual tumor after incomplete staging surgery. For all 163 patients, up-staging was found in 15 patients (15/163, 9.2%). For 44 apparent FIGO stage IA patients, no patient was found to up-stage to FIGO II-IVB. Moreover, both the history of ovarian mucinous tumor (HR=4.745, 95% CI= 1.132-19.886, P=0.033) and bilateral ovaries involved (HR=9.739, 95% CI= 2.016-47.056, P=0.005) were independent risk factors for up-staging to FIGO stage II-IVB. Conclusions: For patients of apparent FIGO stage IA, the possibility of residual tumors and up-staging is relatively low. While for patients of cystectomy, bilateral mucinous carcinomas, or history of ovarian mucinous tumors, complete staging surgery maintains greater significance.