Factors and common sites of ovarian cancer recurrence

Ovarian cancer is easy to metastasize and spread widely. About 3/4 of patients are in the advanced stage when they seek medical treatment. After comprehensive treatment mainly based on surgery, the 5-year survival rate is still only around 30%. The reason for this is that in addition to the difficulty in early diagnosis, recurrence after treatment is an important reason. After stopping treatment, about 50% to 80% of patients who have achieved clinical recovery will relapse in the near or long term.

1 Factors affecting ovarian cancer recurrence

Ovarian cancer usually recurs within 3 years after surgery. The recurrence rate of improperly treated early-stage ovarian cancer is 19%, while the recurrence rate in late-stage cancer is 60% to 85%. Recurrence is related to many factors.

(1) The clinical stage is related to the stage of the disease when it is first treated. Patients with late stage of the disease are more likely to relapse.

(2) Pathological types: It is generally believed that serous papillary cystadenocarcinoma and clear cell carcinoma have a high probability of recurrence.

(3) Residual tumor size The size of the residual tumor after the first tumor cell reduction surgery is related to recurrence, but there is no consensus on the size of the residual tumor as the standard. Some believe that the diameter should be 2 cm, while others believe that the diameter should be 1 cm.

(4) Histological grading Histopathological grading is an important factor in determining the recurrence of patients after complete remission. The higher the grade, the more likely it is to relapse.

(5) Tumor-associated antigen CA125. Patients with high CA125 values ​​are more likely to relapse after treatment.

(6) Irregular treatment and drug resistance: Insufficient chemotherapy drug dosage, prolonged treatment intervals leading to drug resistance, or insufficient total number of treatment courses can all lead to recurrence after treatment.

(7) Ascites cytology Ascites is a sign of spread within the abdominal and pelvic cavities. Patients with positive ascites cytology are prone to recurrence.

(8) Family history of cancer, especially in women

The family history of tumors in the department is mostly glandular epithelial tumors such as ovarian cancer, uterine cancer, and breast cancer. It is inferred that the recurrence of ovarian cancer may be homologous to the occurrence of certain glandular epithelial tumors.

(9) The positive rate of lymph node metastasis: Patients with lymph node metastasis have a high chance of recurrence.

(10) Other patients are in poor condition, are older, have poor immune function and resistance, and the remaining cancer cells may enter the proliferation phase from the dormant phase, which is more likely to lead to cancer recurrence.

2 Sites of ovarian cancer recurrence

The characteristic of ovarian cancer recurrence is multiple recurrence, which may occur in the vagina or other parts of the pelvis, retroperitoneal or para-aortic lymph nodes, liver, spleen, pancreas, gastrocolic ligament, residual greater omentum, diaphragm, intestines and other abdominal organs, as well as pleura, lungs, brain and other parts. The most common sites of recurrence are the pelvic and abdominal cavity and lymph nodes.