Metastases observed autopsy in 70 women with ovarian-cancer - relationship to treatment

We conducted a 20-year retrospective survey of 6.457 autopsied cases to select those women who died of primary ovarian carcinoma. Our objective was to determine the incidence and the sites of the metastases in those treated with or without combination chemotherapy based on cis-diamine dichloride platinum (CDDP). In the 70 cases so identified, epithelial ovarian tumors were the most common, found in 52 of the 70 cases. There were 14 cases of germ cell tumors and 2 cases each of sarcoma and stromal cell tumors. Metastases involved the peritoneum in the majority of cases (87%). The liver was the next most frequently affected (73%), followed by the spleen (47%) and the lung (44%). Of the 70 cases, 33 (47%) had received CDDP, while a regimen of 5-fluorouracil, doxorubicin, mitomycin C and toyomycin (FAMT) was administered to 11 cases (15.7%) and radiotherapy to 10 cases (14.3%). Patients who received a CDDP regimen survived longer (23.4 months) than those treated with FAMT (19.2 months) or with other regimens (13.6 months). The most common cause of death was carcinomatosis (48/70 cases). The high incidence of pulmonary, hepatic and splenic metastases in women with primary ovarian cancer indicates the need to direct anticancer treatment toward those sites to thus improve survival.