Primary peritoneal serous papillary carcinoma: A new epidemiologic trend? A matched-case comparison with ovarian serous papillary cancer

The aim of the study was to examine the prevalence of primary peritoneal se rous papillary carcinoma (PPSPC) as compared with ovarian serous papillary cancer (OSPC), and to study the clinicopathologic features and the frequenc y of germline BRCA(1) and BRCA(2) mutations in patients with PPSPC compared with those with OSPC. The study group included 28 cases of PPSPC. The comp arison group included 35 female patients with OSPC, matched for stage, grad e, and histologic subtype. All tumors were staged as either IIIB, IIIC or I V according to FIGO criteria. The patient characteristics, family and perso nal history of malignancies, the prevalence of germline BRCA mutations, cli nicopathologic findings, presenting symptoms, pre- and intraoperative findi ngs, and survival were compared in a matched-case retrospective study compa ring patients with PPSPC vs. those with OSPC. Statistical analysis was made using Student's t-test, Chi-square, Wilcoxon, Kaplan-Meier and log-rank me thods. Women with PPSPC had a significantly earlier menarche (P=0.037) and a higher number or births (P=0.03) than women with OSPC. No difference was found with regard to the prevalence of germline BRCA mutations in women wit h PPSPC compared with women with OSPC (7.1% vs. 25.7%). There was a signifi cant increase (P=0.02) in the incidence of abdominal distension as reported by PPSPC (64%) vs. OSPC patients (26%). Significantly more women with PPSP C than with OSPC presented with clinical ascites (P=0.0001) and without pal pable pelvic mass (P=0.000001). On exploratory laparotomy, significantly mo re women with PPSPC than with OSPC had a minimal disease in the pelvis (P=0 .0087). Three-year survival analysis demonstrated a significantly worse sur vival rate for the PPSPC group than for the OSPC group (P=0.017). A signifi cant increase in the prevalence of PPSPC compared with OSPC was observed du ring the study years (P=0.00001). We concluded that PPSPC and OSPC might be two distinct cancers, presenting a new epidemiologic trend regarding the i ncreased incidence of PPSPC.