Clinical characteristics and survival of patients with normal-sized ovarian carcinoma syndrome: Retrospective analysis of a single institution 10-year experiment

Table 1 Clinical characteristics of the patients with normal size ovarian cancer syndrome and papillary serous ovarian carcinoma, n (%)

Characteristic, patients with data available	NOCS	PSOC	P value
Age in yr	53.76 (110)	52.61(152)	0.400
Menopausal status			0.579
Premenopausal	39 (35.4)	59 (38.8)
Postmenopausal	71 (64.6)	93 (61.2)
Initial symptoms			0.003
Abdominal distension	70 (63.6)	63 (41.4)
Abdominal pain	20 (18.2)	26 (17.1)
Mass	5 (4.5)	54 (35.5)
Other	15 (15.6)	9 (5.9)
CA125 in U/mL	1318.04	1863.38	0.039
CA199 in U/mL	51.41	28.52	0.202
Ascites cytology			0.057
Positive	47 (88.6)	34 (73.9)
Negative	6 (11.3)	12 (26.1)
Ascites in mL	1658.63	2302.24	0.025
Misdiagnosis rate	23.6%	1.32%	0.000
Survival rates			0.179
1-year	75.5%	64.5%
3-year	27.7%	23.0%
5-year	13.8%	9.9%

CA: Carbohydrate antigen; NOCS: Normal size ovarian cancer syndrome; PSOC: Papillary serous ovarian carcinoma.

Table 2 Clinical characteristics of the patients with normal size ovarian cancer syndrome in four histological subtypes

Characteristic	Primary adnexal	MPM	EPSPC	Metastatic
n (%)	80 (72.7)	2 (1.8)	19 (17.3)	9 (8.2)
Age in yr	53.28 (24-67)	51.50 (45-58)	56.42 (44-72)	53.00 (35-66)
Menopausal status
Premenopausal	13	0	1	2
Postmenopausal	67	2	18	7
Initial symptoms
Abdominal distension	52	2	12	4
Abdominal pain	14	0	5	1
Mass	3	0	1	1
Other	11	0	1	3
CA125 in U/mL	1465.40	36.81	1308.14	205.40
CA199 in U/mL	22.61	13.2	83.87	244.63
Ascites cytology	62	1	14	6
Positive, n (%)	37 (59.7)	1 (100)	8 (57.1)	4 (66.7)
Negative, n (%)	25 (40.3)	0 (0)	6 (42.9)	2 (33.3)
Ascites in mL	1717.87	1000	1500	1480
Stage, n (%)
III	58 (72.5)	2 (100)	12 (63.2)	6 (66.7)
IV	22 (27.5)	0 (0)	7 (36.8)	3 (33.3)
Survival rates
1-year	79.5%	100%	64.7%	66.7%
3-year	32.1%	100%	23.5%	33.3%
5-year	20.5%	50%	5.9%	22.2%

CA: Carbohydrate antigen; EPSPC: Extraovarian peritoneal serous papillary carcinoma; MPM: Malignant peritoneal mesothelioma.

Table 3 Treatment characteristics of primary normal size ovarian cancer syndrome and papillary serous ovarian carcinoma, n (%)

Characteristic, patients with data available	NOCS	PSOC	P value
Initial surgery			0.892
Complete	79 (71.8)	108 (71.1)
Incomplete	31 (28.2)	44 (28.9)
Operation method			0.000
Laparotomy	49 (44.5)	112 (73.7)
Laparoscopy	61 (55.5)	40 (26.3)
Residual tumor			0.136
Yes	67 (60.9)	106 (69.7)
No	43 (39.1)	46 (30.3)
Chemotherapy			0.000
Platinum-based	86 (77.3)	142 (93.4)
Nonplatinum-based	3 (2.7)	0 (0.0)
Without	22 (20)	10 (6.6)
Chemotherapy numbers			0.051
≥ 6	58 (65.2)	74 (52.1)
< 6	31 (34.8)	68 (47.9)

Complete: Standard ovarian tumor staging operation (hysterectomy + bilateral appendage resection + omentectomy + pelvic lymph node dissection + tumor cell reduction); Incomplete: Non-standard ovarian tumor staging operation. NOCS: Normal size ovarian cancer syndrome; PSOC: Papillary serous ovarian carcinoma.

Table 4 The Cox regression models for normal size ovarian cancer syndrome-specific survival prognostic factors in the univariate analysis

Factors	Overall survival			Progression-free survival
	Hazard ratio	95%CI	P value	Hazard ratio	95%CI	P value
Age ≥ 50 yr	1.314	0.594-2.906	0.500	0.736	0.290-1.871	0.520
CA125 ≥ 100 in U/mL	3.751	0.898-15.664	0.070	1.163	0.333-4.058	0.813
CA199 ≥ 35 in U/mL	2.546	1.156-5.608	0.020	1.778	0.483-6.543	0.387
Ascites ≥ 1000 in mL	1.954	0.987-3.870	0.055	1.248	0.567-2.747	0.582
Stage III vs IV	1.517	0.688-3.347	0.302	0.617	0.238-1.603	0.322
Residual tumor	2.348	0.969-5.691	0.059	1.059	0.431-2.599	0.901
Complete surgery	1.632	0.948-3. 061	0.512	0.842	0.267-2.134	0.534
Differentiation	0.047	0.000-42.817	0.512	0	0	0
Histological subtype	1.023	0.818-2.342	0.342	0.736	0.278-1.899	0.365
Operation method	0.541	0.268-1.091	0.086	1.114	0.512-2.424	0.785
Platinum-based CT	0.355	0.083-1.522	0.163	0.682	0.085-5.474	0.719
Chemotherapy numbers ≥ 6	0.307	0.138-0.684	0.004	0.384	0.117-1.261	0.115

CA: Carbohydrate antigen; CI: Confidence interval; CT: Computed tomography.

Table 5 The Cox regression models for normal size ovarian cancer syndrome-specific survival in the multivariate analysis

Factors	Overall survival
	HR	95%CI	P value
CA125 ≥ 100 in U/mL	0.785	0.093-6.589	0.823
CA199 ≥ 35 in U/mL	3.004	1.133-7.960	0.027
Ascites ≥ 1000 in mL	1.935	0.814-4.599	0.135
Residual tumor	1.417	0.492-4.078	0.518
Chemotherapy numbers ≥ 6	0.313	0.127-0.770	0.012
Histological subtype	1.124	0.744-3.451	0.235
Stage	0.769	0.642-3.477	0.176
Operation method	1.213	0.984-3.461	0.115

CA: Carbohydrate antigen; CI: Confidence interval.