Different Patterns of Disease Spread between Advanced-Stage Type i and II Epithelial Ovarian Cancer

Alice Bergamini, Massimo Candiani, Gianluca Taccagni, Emanuela Rabaiotti, Riccardo Viganò, Patrizia De Marzi, Davide Ferrari, Giorgia Mangili

Research output: Contribution to journalArticlepeer-review


Two types of epithelial ovarian carcinoma (EOC) have been recently distinguished. Type I comprises low-grade serous, endometrioid and clear-cell tumors. High-grade endometrioid and serous tumors belong to type II. The aim of this study was to compare patterns of disease spread in advanced-stage type I and II EOCs at primary surgery. Methods: Surgical and pathological data of 233 patients with advanced-stage EOCs were collected, 42 with type I and 191 with type II. The two groups were compared for tumor localization at primary surgery. Intraoperative mapping of ovarian cancer (IMO) was used to assess tumor dissemination. Results: Tumor involvement was significantly higher in the type II group for the following: peritoneum (68.1 vs. 40.5%, p <0.001), pouch of Douglas (60.2 vs. 40.5%, p = 0.06), vesicouterine ligament (40.8 vs. 19%, p = 0.027), diaphragm (45.0 vs. 11.9%, p <0.001), serosa of liver (17.2 vs. 4.8%, p = 0.05), omentum (81.1 vs. 59.5%, p = 0.007), mesentery (42.9 vs. 16.7%, p = 0.005), pleural effusions (19.4 vs. 4.6%, p = 0.01) and ascites (60.7 vs. 21.4%, p <0.001). IMO levels were different between the two groups (p = 0.001). Conclusions: This study provides clinical evidence in favor of the dualistic model of carcinogenesis, since types I and II are characterized by different findings at primary surgery.

Original languageEnglish
Pages (from-to)10-14
Number of pages5
JournalGynecologic and Obstetric Investigation
Issue number1
Publication statusPublished - Jan 1 2016


  • Advanced stage
  • Disease spread
  • Epithelial ovarian cancer

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine


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