Clinical picture of women with early stage ovarian cancer

Objective. The objective of this study was to review the clinical picture of women with early stage ovarian cancer, to examine the difference between women with borderline ovarian tumors (BLOT) and those with ovarian cancer (OC), and to estimate the average time interval between the onset of symptoms and diagnosis. Methods. A retrospective review of all women with surgical stage I and II OC or BLOT was performed and the following information abstracted: age, parity, family history of cancer, personal history of previous malignancies, symptoms, signs, date of start of symptoms, imaging studies, CA-125 values, date of diagnosis at surgery, tumor stage, histology, grade, date of last followup, and condition at last follow-up. Comparison between patients with BLOT and OC was performed using chi(2) and two-sample t tests. Results. Our search identified 72 women with surgical stage I and II BLOT (n = 22) or OC (n = 50). Seventy-eight percent of the patients had presenting symptoms, the most common of which were abdominal or pelvic pain (34.7%), bloatedness (31.9%), and vaginal bleeding (19.4%). Symptoms were similar among women with BLOT and those with OC, with a higher proportion of BLOT patients reporting no symptoms (31.8% versus 18.0%, respectively). Abdominal and/or pelvic masses were palpable in 72.2% of the patients and ascites was present in 12.5%. Ovarian masses were most commonly complex in appearance and CA-125 was elevated in 52.2% of the patients in whom CA-125 values were known. The average time interval between onset of symptoms and diagnosis was 4.6 months (range 0.1-24.4 months). Women with BLOT had a significantly longer average time interval than women with OC (8.0 +/- 7.7 versus 3.4 +/- 3.7 months, respectively, P = 0.03). Conclusions. The majority of women with early stage ovarian cancer have nonspecific symptoms. The array of symptoms is similar between women with BLOT and those with OC. However, women with BLOT tend to have a longer time interval from onset of symptoms to diagnosis. (C) 1999 Academic Press.