From the Guidelines
Ovarian cancer is the most likely to spread to the uterus due to its anatomical proximity and shared lymphatic drainage. The spread typically occurs through direct extension, lymphatic channels, or blood vessels. According to a recent study published in 2024 1, ovarian cancer is the second-highest cause of death among all gynaecological cancers, and more than 90% of malignant ovarian tumours are designated tubo-ovarian carcinoma. This highlights the high likelihood of ovarian cancer spreading to nearby organs, including the uterus. Other cancers that may metastasize to the uterus include colorectal, breast, gastric, pancreatic, and bladder cancers, though less frequently.
Some key points to consider when evaluating the spread of cancer to the uterus include:
- Anatomical proximity and shared lymphatic drainage between the ovaries and uterus
- The type of cancer, with ovarian cancer being the most common source of metastasis to the uterus
- The mode of spread, which can occur through direct extension, lymphatic channels, or blood vessels
- The importance of determining whether cancer found in the uterus represents a primary uterine cancer or metastasis from another site, as this distinction significantly impacts treatment approaches.
It's worth noting that metastatic cancer to the uterus is actually less common than primary uterine cancers, such as endometrial carcinoma. However, when cancer is found in the uterus, physicians will conduct imaging studies, biopsies, and immunohistochemical testing to determine the origin of the cancer 1.
From the Research
Cancers that Spread to the Uterus
- Ovarian cancer is one of the most common cancers to spread to the uterus, as it can metastasize through various routes, including peritoneal, hematogenous, lymphatic, and nerve-related paths 2.
- Uterine cancer itself can also spread to other parts of the body, including the lungs, liver, bones, and brain, but it is less likely to spread to the uterus from other primary sites 3.
- Cervical cancer can also metastasize to the uterus, although it is more likely to spread to the lungs, liver, bones, and brain 3.
Metastasis Patterns
- The most common locations for distant metastases in ovarian cancer patients are the liver, lungs, bones, and brain, with the liver being the most frequent site 3.
- Uterine cancer patients are more likely to have distant metastases in the lungs, liver, bones, and brain, with the lungs being the most frequent site 3.
- Cervical cancer patients are also more likely to have distant metastases in the lungs, liver, bones, and brain, with the lungs being the most frequent site 3.
Treatment and Prognosis
- The treatment and prognosis for ovarian, uterine, and cervical cancer patients with distant metastases depend on various factors, including the location and extent of metastases, performance status, and residual disease after primary surgery 3, 4.
- Bevacizumab, carboplatin, and paclitaxel are commonly used in the first-line treatment of advanced ovarian cancer, and their efficacy and safety have been demonstrated in several studies 5, 4.