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Advanced stage primary mucinous ovarian carcinoma. Where do we stand ?

A Correspondence to this article was published on 15 June 2020

A Correspondence to this article was published on 08 June 2020



To evaluate factors associated with survival of patients with advanced stage mucinous ovarian carcinoma (MOC) using a large multi-institutional database.


Patients diagnosed between 2004 and 2014 with advanced stage (III–IV) MOC were identified within the National Cancer Database. Those without a personal history of another primary tumor who received cancer-directed surgery with a curative intent were selected for further analysis. Overall survival (OS) was evaluated with Kaplan–Meier curves, and compared with the log-rank test. Multivariate Cox analysis was performed to identify independent predictors of survival.


A total of 1509 patients with a median age of 59 years (IQR 20) met the inclusion criteria: stage III (n = 1045, 69.3%) and stage IV disease (n = 464, 30.7%). Patients who received chemotherapy (n = 1065, 70.6%) had better OS compared to those who did not (n = 385, 25.5%), (median OS 15.44 vs 5.06 months, p < 0.001). The type of reporting facility (p = 0.65) and the year of diagnosis (p = 0.27) were not associated with OS. Presence of residual disease was strongly associated with OS (p < 0.001). After controlling for confounders, the administration of chemotherapy (HR 0.63, 95% CI 0.55, 0.72) was associated with better survival.


Advanced stage MOC has an extremely poor prognosis. Patients who received chemotherapy had a small improvement in survival. Every effort to achieve complete gross resection should be performed. Given no improvement in survival outcomes over time, there is an eminent need for novel treatment options.

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Authors and Affiliations



DN: Conception, Protocol/project development, Data collection and management, Data analysis and interpretation, Manuscript writing/editing. BAA: Protocol/project development, Data interpretation, Manuscript writing/editing. AFH: Data interpretation, Manuscript writing/editing. RGII: Data interpretation, Manuscript writing/editing. RAB: Data interpretation, Manuscript writing/editing. MAM: Data interpretation, Manuscript writing/editing. EK: Data interpretation, Manuscript writing/editing. NAL: Supervision, Protocol/project development, Data interpretation, Manuscript writing/editing.

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Correspondence to Dimitrios Nasioudis.

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All authors declare no potential conflict of interest, including and financial or personal relationship which could be viewed as one.

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The National Cancer Database is available to the public for research purpose. All patient data are de-identified. The present study was deemed exempt by the institutional review board.

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Nasioudis, D., Albright, B.B., Ko, E.M. et al. Advanced stage primary mucinous ovarian carcinoma. Where do we stand ?. Arch Gynecol Obstet 301, 1047–1054 (2020).

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  • Ovary
  • Cancer
  • Mucinous
  • Advanced stage