What is the 5-year survival rate for mucinous ovarian carcinoma?

Survival Rates for Mucinous Ovarian Carcinoma

Patients with mucinous ovarian carcinoma have a 5-year disease-specific survival rate of approximately 80-90% overall, with excellent prognosis in early-stage disease but significantly worse outcomes in advanced stages. 1, 2

Survival by Stage and Grade

• Patients with early-stage mucinous ovarian carcinoma (MOC) have an excellent prognosis with 5-year disease-free survival of approximately 91.1% for FIGO stage I disease 2
• Grade 1 stage I patients (representing the majority of MOC cases at 53%) demonstrate exceptional survival with 10-year disease-specific survival of 95.3% 2
• Survival rates decline significantly with advanced stage:
  • Stage II: 76.7% 5-year disease-free survival 2
  • Stage III/IV: Only 19.8% 5-year disease-free survival 2
• Survival also correlates strongly with tumor grade:
  • Grade 1: 89.5% remain disease-free at 5 years 2
  • Grade 2: 74.9% remain disease-free at 5 years 2
  • Grade 3: 41.7% remain disease-free at 5 years 2

Comparison to Other Ovarian Cancer Types

• In early-stage disease, MOC has a better prognosis compared to serous ovarian carcinoma (SOC) 3
• In advanced-stage disease (FIGO III-IV), MOC has significantly worse outcomes than SOC:
  • Higher risk of dying within 5 years (Risk Ratio 1.15) 3
  • Shorter survival (Hazard Ratio 1.82) 3
• Among patients with complete response after first-line treatment, 5-year overall survival rates by histology are:
  • Mucinous: 71.4% 4
  • Endometrioid: 67.1% 4
  • Serous: 51.5% 4
  • Clear cell: 50.8% 4

Recurrence Risk

• The risk of recurrence after a disease-free period is relatively low for MOC patients:
  • 8.3% risk of recurrence over the next 10 years after being disease-free for 2 years 2
  • 5.6% risk of recurrence over the next 10 years after being disease-free for 5 years 2
• However, median post-relapse survival is extremely poor at only 5.0 months 2

Prognostic Factors

• Independent prognostic factors for disease-specific survival in MOC include:
  • FIGO stage (p<0.001) 2
  • Pathological grade (p<0.001) 2
• Residual tumor after primary surgery significantly impacts 5-year survival:
  • 71.2% for residual tumor ≤1 cm 4
  • 46.9% for residual tumor >1 cm 4
• Age is also a significant factor, with younger patients (<52 years) having better 5-year survival (65.1%) compared to older patients (51.2-51.4%) 4

Treatment Considerations and Challenges

• MOC demonstrates relative resistance to standard ovarian cancer chemotherapy regimens 5
• In advanced-stage MOC, the effects of chemotherapy and debulking surgery on 5-year survival are limited:
  • Debulking: 12% vs 8% without debulking (p<0.01) 6
  • Chemotherapy: 12% vs 10% without chemotherapy (p=0.02) 6
• Survival of advanced-stage MOC is comparable to that of synchronous metastases to the ovary (11% 5-year survival for both) 6
• A significant challenge in MOC management is distinguishing primary MOC from metastatic disease, particularly from gastrointestinal primaries 1, 6

Clinical Implications

• MOC typically presents at a younger age (20-40 years) than high-grade serous ovarian cancer 1
• MOC often presents as large cystic masses that may fill the entire abdominal-pelvic cavity 1
• Additional workup for suspected MOC should include gastrointestinal tract evaluation and CEA level to distinguish primary from metastatic disease 1, 7
• For patients with stage IA or IB mucinous tumors, postoperative observation and monitoring are recommended as most of these tumors are benign or borderline 1