Secondary ovarian carcinoma: a clinical and pathological evaluation

A retrospective clinical and pathological analysis was performed of 96 patients with secondary ovarian carcinoma diagnosed between January 1972 and June 1985 at New York University Medical Center. Secondary tumors accounted for 17.4% (96/553) of ovarian malignancies. The most common sites of origin were breast (32 cases), unilateral ovary (with contralateral metastases) (20), endometrium (14), colon (12), stomach (6), cervix (2), ileum (2), and 1 each for 8 additional sites. The patients ranged in age from 19 to 87 years, averaging 54.8 years, and 55 patients were postmenopausal. Ninety percent of the patients had extraovarian metastases at the time of abdominal surgery. The ovarian metastases tended to be bilateral for breast, colon and stomach, and unilateral for endometrial and ovarian primary sites. The metastases tended to be solid except for colon. The overall survival rate was 24.1% at 5 years and 7.1% at 10 years. Comparison of median survival times for the various major primary sites showed a significant overall difference (p = 0.04) and was as follows: gastric primary 0.79 years, breast 1.9 years, ovary 2.0 years, colon 3.0 years, and endometrium 3.4 years. Postmenopausal patients with unilateral ovarian carcinoma and contralateral metastases had a significantly (p = 0.04) longer median survival time (4.2 years) than analogous premenopausal patients (1.3 years). For breast and endometrium, menopausal status was not significantly associated with survival differences. These findings should prove useful in the differential diagnosis of ovarian tumors and in the medical management of these patients.