33 Survival trends and feasibility of surgery in ovarian cancer patients with rare metastatic sites

Introduction/Background* Ovarian cancer is the commonest gynaecologic malignancy in Egypt after breast cancer. Although metastasis from ovarian cancer is common, there is still sites with rarely reported deposits as non-regional nodes, bone, and brain. Methodology We herein study retrospectively a group of patients over 7 years period recruited from data system of tertiary cancer centre. All the recruited patients suffered a rare distant metastasis from ovarian cancer (metastasis to sites other than peritoneum, liver, and lung). Demographic data, pathology, surgical treatment, and survival of these patients were analysed. Result(s)* Out of 1135 ovarian cancer patients, 48 patients with FIGO stage IV rare metastatic sites were enrolled. The most common site of rare metastasis was the non-regional lymph nodes (56.3%), while the most common pathology was high grade serous carcinoma (87.5%). Nearly half of the cases presented with the metastasis, while the rest developed during disease course. Interestingly, debulking was feasible in nearly a half of the patients with acceptable overall and progression free survival. Patients with non-regional nodal metastases tend to have better overall survival (39 vs 13 months p=0.003) (figure 1) and progression free survival (29 vs 13 months p= 0.034) than visceral or skeletal metastasis. Conclusion* Ovarian cancer can metastasize to rare sites. Non-regional nodes were the commonest and had better survival trends than other rare sites of metastasis. Although surgical treatment was feasible in nearly half the cases with an accepted overall and progression free survival, we could not detect survival benefit of surgical resection in these patients (figure 2).