Mucinous ovarian neoplasm – outcomes of a rare tumor

Background: Mucinous epithelial ovarian (mEO) tumors are rare entities. In this study, we describe the management and outcomes of patients treated for mucinous borderline tumor and mucinous adenocarcinoma of the ovary. Methods: This was a retrospective review of patients with mEO tumors from 1988 − 2021 from a single institution database. Primary outcomes were disease recurrence and death within five years post-surgery, evaluated using Cox proportional hazards and Kaplan-Meier survival analysis. Results: We identified 262 patients with mEO tumors with a mean age of 54.9 years. One-hundred and forty-three patients (55 %) had borderline tumors and 119 (45 %) adenocarcinoma. Most patients underwent complete surgical resection (95 %).Those with mucinous borderline tumors had favorable prognosis, with 5-year progression-free survival (PFS) and overall survival (OS) of 97%. Among patients with mucinous adenocarcinoma, 5-year PFS was 78% and 5-year OS was 80%. Fifty-seven patients with adenocarcinoma (48%) received adjuvant chemotherapy.In univariate analysis, adenocarcinoma histology, residual disease, advanced FIGO stage (II-IV), and receipt of adjuvant chemotherapy were associated with recurrence and death within five years of surgery. While a considerable proportion of patients in both cohorts underwent gastrointestinal (GI) endoscopy, all findings were negative/benign. Conclusions: Mucinous tumors of the ovary have overall favorable survival outcomes. In this cohort, residual disease, histopathology, and receipt of adjuvant chemotherapy were associated with disease recurrence. In addition, GI workup was of limited utility. Further study is needed to clarify ideal adjuvant treatment and GI workup.