Comparison of long-term oncologic outcomes between metastatic ovarian carcinoma originating from gastrointestinal organs and advanced mucinous ovarian carcinoma

  • Hiroaki KajiyamaEmail author
  • Shiro Suzuki
  • Fumi Utsumi
  • Nobuhisa Yoshikawa
  • Kimihiro Nishino
  • Yoshiki Ikeda
  • Kaoru Niimi
  • Eiko Yamamoto
  • Michiyasu Kawai
  • Kiyosumi Shibata
  • Tetsuro Nagasaka
  • Fumitaka Kikkawa
Original Article



Occasionally, ovarian tumors are found to have originated from non-ovarian organs as metastatic lesions since the ovary is a common site of metastasis from many cancers. The aim of the current study was to estimate the long-term oncologic outcome of patients with metastatic mucinous ovarian carcinoma (MmOC) in comparison with those with primary mucinous ovarian carcinoma (PmOC) at an advanced stage.

Materials and methods

The data of one hundred and sixty-seven patients with mucinous ovarian cancer, including 91 patients with MmOC from the digestive organs and 76 patients with stage III–IV PmOC, were retrospectively analyzed. The prognostic significances of clinicopathologic factors were evaluated employing both uni- and multivariable analyses. Pathological slides were evaluated based on centralized pathological review.


The median age of patients with PmOC and MmOC was 55 (18–81) and 51 years (30–82), respectively. With follow-up of a total of 167 patients, 145 patients (86.8%) developed recurrence. In addition, 122 patients (73.0%) died of the disease. Regardless of the residual tumor status, patients with PmOC did not a show a significantly poorer OS than those with MmOC. Furthermore, in a Cox multivariable hazard model, after adjustment for various clinicopathologic confounders, a gastric cancer (GC)-originated tumor and larger residual tumor were significant predictors of poorer OS [GC (vs. PmOC): HR (95% CI) 2.205 (1.303–3.654), P = 0.0036].


The oncologic outcome of patients with MmOC was extremely poor; however, it was almost the same as that of those with PmOC. We should recognize MmOC derived from gastric carcinoma as a highly aggressive malignancy.


Metastatic ovarian carcinoma Mucinous epithelial ovarian carcinoma Overall survival Residual tumor Gastric carcinoma 



Primary mucinous ovarian carcinoma


Metastatic mucinous ovarian carcinoma


World Health Organization


International Federation of Gynecology and Obstetrics


Overall survival


Gastric carcinoma


Colorectal carcinoma



We sincerely thank all members of the Tokai Ovarian Tumor Study Group for collaborating in data collection.

Author contribution

HK: data analysis and interpretation, writing manuscript, SS, FU, YI, KN, KN, MK, and NY: data collection, TN: pathological evaluation, KS: supervisor of this work, FK: supervising and funding.


This study was supported by JSPS (Japan Society for the Promotion of Science) KAKENHI Grants-in-Aid for Scientific Research: Grant Numbers 17H04338 and 16K15704.

Compliance with ethical standards

Conflict of interests

The authors have nothing to disclose.


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Hiroaki Kajiyama
    • 1
    Email author
  • Shiro Suzuki
    • 1
  • Fumi Utsumi
    • 2
  • Nobuhisa Yoshikawa
    • 1
  • Kimihiro Nishino
    • 1
  • Yoshiki Ikeda
    • 1
  • Kaoru Niimi
    • 1
  • Eiko Yamamoto
    • 1
    • 3
  • Michiyasu Kawai
    • 4
  • Kiyosumi Shibata
    • 2
  • Tetsuro Nagasaka
    • 5
  • Fumitaka Kikkawa
    • 1
  1. 1.Department of Obstetrics and GynecologyNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of Obstetrics and Gynecology, Bantane HospitalFujita Health UniversityNagoyaJapan
  3. 3.Department of Healthcare Administration, Graduate School of MedicineNagoya UniversityNagoyaJapan
  4. 4.Department of Obstetrics and GynecologyToyohashi Municipal HospitalToyohashiJapan
  5. 5.Department of Medical Technology, School of Health ScienceNagoya University Graduate School of MedicineNagoyaJapan

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