OVARIAN INVOLVEMENT BY SEROUS SURFACE PAPILLARY CARCINOMA

Serous surface papillary carcinoma (SSPC) is a multicentric peritoneal tumor that can spare or minimally involve the ovaries and has been re ported to be more aggressive than the usual form of serous carcinoma o f the ovary (SCO). From 360 serous ovarian carcinomas, we selected 87 cases with high histological grade, clinical stage III, residual disea se after the first operation, similar chemotherapeutic regimens, and a t least a 4-year follow-up period. Of these, 33 patients had SSPC in w hich the tumors were smaller than 10 mm (ovaries not enlarged), and 54 had SCO in which the tumors were larger than 5.0 cm. The 33 cases wit h SSPC were then subdivided according to tumor size: (a) 17 patients h ad SSPC characterized by tumors that were smaller than 5.0 mm in large st dimension and that involved only the ovarian surface or showed mini mal superficial invasion of the ovarian cortex (maximum depth, 3 mm); (b) 16 patients had SSPC characterized by tumors that measured 5.1 to 10 mm and involved the ovarian surface, cortex, and/or medulla. The su bdivision of the SSPC into small and large types was found to be of no clinical statistical significance: thus, the two groups were recombin ed as a single group. The difference in length of survival between SSP C and SCO at 24 months (39% versus 32%, respectively) and the median s urvival times (SSPC = 17 months and SCO = 18 months) were not statisti cally significant. However, the 48-month survival rate (SSPC = 28% and SCO = 9%), was statistically significant (p - 0.027). The SSPC group had a better long-term prognosis than did the SCO group. Both groups h ad a similar median survival time.