Extraovarian Peritoneal Cancer Prognosis

Extraovarian Peritoneal Cancer Prognosis
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Extraovarian cancer is also known as extraovarian primary peritoneal cancer (EOPPC).

It is a cancer that develops in the abdominal cavity where the protective covering, the peritoneum, keeps the organs moist and protected from injury. This type of cancer presented more recently by women that had received bi-lateral salpingo-oophorectomies, the removal of both tubes and ovaries. The absence of ovaries did not preclude the cancer that presented ovarian tissue. The correlation between ovarian and peritoneal cancer is the mesothelial tissue that is found in the peritoneum and ovaries. Extraovarian peritoneal cancer prognosis depends on early detection of the disease.

A distinctive characteristic of the disease is small microscopic tumors, diffused throughout the peritoneal area not giving light to any primary site. The disease can appear as ovarian cancer, be treated in the same manner, but it is not ovarian cancer.

Symptoms

The most common symptoms of the disease are; nausea and vomiting, distention of the abdomen (bloating), a change in bowel habits, and pain in the lower back and legs. The most common symptom is fluid build up in the abdomen.

Diagnosis

White women between the ages of 57 and 66 present with the disease more than other groups according to John Hopkins University Hospital and as much as 21.2% have undergone bi-lateral oophorectomy before the onset of the disease. Most peritoneal ovarian cancers are not detected until stage 3 because of a lack of symptoms.

There are several methods of diagnosis. The blood test known as CA-125 is an indicator of the disease, biopsy of abdominal tissue and examination of the peritoneal fluid are also used. Ultrasound and CT scan may or may not be effective depending on the size of the tumors.

Prognosis

In most cases surgery is used to remove the infected areas and eliminate the spread of the cancer. Removal of the uterus, tubes, ovaries, and bowel may be necessary. Removal of each tumor is called cytoreduction (debulking). Chemotherapy and radiation are used as additional treatment after surgery.

Extraovarian peritoneal cancer prognosis is determined by the staging of the disease. Staging is the size of the tumors and the number that are left after surgery. There are 13 regions in the abdomen and each tumor is given a number according to size. The highest score possible is 39. The lowest score is given the best prognosis. Cytoreduction is scored before and after surgery. The Completeness of Cytoreduction Score, CC, is important in defining a prognosis. The higher CC score, the lower survival rate. The tumor size is recorded from 2.5mm to 2.5cm. The lowest score is a CCO score meaning that all of the tumors were removed and a CC3 means that remaining tumors in the abdomen were 2.5 cm. or larger.

Survival rates for individuals depend on treatment, CC score, stage of the disease and recurrence. The overall 5 year life expectancy is 41% with the mean at 63 months give or take 8 months. Recurrence is 23.3%.

Extraovarian peritoneal cancer prognosis can be more favorable with early detection. One test that has proven to detect the disease in the early stages is the CA-125. If you have a history of ovarian cancer in your family, insist that your doctor administers a blood test for CA-125 every year.

References

Cancer Decisions: Extra Ovarian Primary Peritoneal Cancer (EOPPC ) - https://www.cancerdecisions.com/mrstore/index.php?main_page=product_info&cPath=9_12_76&products_id=601

John Hopkins Pathology: Ovarian Cancer Prognostic Factors - https://ovariancancer.jhmi.edu/prognosis.cfm

PubMed Central Journal List: Advanced primary peritoneal carcinoma: clinicopathological and prognostic factor analyses - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408695/

Pub Med: Peritoneal cancer index: a prognostic indicator of survival in advanced ovarian cancer - https://www.ncbi.nlm.nih.gov/pubmed/12559080

The Appendix Cancer Connection: Staging of Peritoneal Cancer - https://appendix-cancer.com/Staging%20of%20Peritoneal%20Cancer.htm