Natural history of mucinous ovarian cancer in Ireland.
e17056 Background: Mucinous ovarian neoplasmscan arise as benign, borderline or malignant disease. Primary mucinous epithelial ovarian carcinoma (mEOC) represents 3% of invasive EOC. Differentiating primary from metastatic mucinous ovarian cancer is challenging. Systemic management of mucinous ovarian cancer increasingly follow GI cancer treatment protocols. We examined retrospective data at our institution to investigate incidence, management and site of origin of mEOC. Methods: 1,333 ovarian malignancies either diagnosed at or referred to St James Hospital, Dublin (from 2000 – 2016) were evaluated. The diagnosis was based on reported pathology. Patient demographics and investigations were retrospectively analyzed. Tumours were graded according to FIGO criteria. Results: Between 1/1/2000 and 9/12/2016 1,333 primary ovarian malignancies were diagnosed at our institution. 48 (3.6%) of these were mucinous adenocarcinoma and a further 5 (0.38%) were endometriod carcinoma of the ovary with mucinous differentiation. The average age at diagnosis was 48 (range 19-77 years). The majority of cases (87.5%) were stage I (IA 23, IB 2, IC 17, II 0, IIIA 1, IIIB 1, IIIC 3, IV 1) Staging CT thorax, abdomen and pelvis was completed in 44/48 cases and 24/48 (50%) patients underwent endoscopic evaluation of the uper or lower GI tract: 11 (22.9%) patients had both upper and lower GI endoscopy, 8 (16.7%) underwent OGD only and 5 (10.4%) had colonoscopy only. Gastrointestinal malignancy was not diagnosed in any of the patients. A total of 3 patients had immunohistochemistry for mismatch repair proteins performed, all of which demonstrated normal staining. All patients underwent surgical resection, 14 (29.2%) received adjuvant chemotherapy. 12 (25%) patients have died with a median OS of 11.5 months (range 7-108 months). Median follow up is 20.5 months (range 1-85 months) Conclusions: The incidence of mEOC in our population is 3.6%. The majority of patients diagnosed with mEOC over a 16 year period are still alive without evidence of disease, suggesting the diagnosis were ovarian in origin rather than metastatic. Immunohistochemistry for mismatch repair proteins is ongoing and will be presented at the meeting.