A Comparative Study of Radiologic Characteristics between Primary and Secondary Ovarian Cancer
Keywords:
มะเร็งรังไข่ปฐมภูมิ, มะเร็งรังไข่ทุติยภูมิ, เอกซเรย์คอมพิวเตอร์, การวินิจฉัยทางรังสีวิทยาAbstract
Background: Ovarian cancer is a significant public health concern. Differentiating between primary and secondary ovarian cancer is crucial for treatment planning. However, specific radiologic characteristics that can aid in distinguishing between the two types remain limited.
Objective: To study and compare the radiologic features observed through abdominal computed tomography (CT) imaging that can be used to differentiate primary from secondary ovarian cancer.
Methods: A retrospective analytical study was conducted on 255 patients diagnosed and treated for ovarian cancer at Sappasithiprasong Hospital, Ubon Ratchathani, between October 1, 2021, and September 30, 2024. Radiologic characteristics were analyzed based on abdominal CT images, with histopathological findings as the reference standard. Statistical analysis included quantitative data presented as mean ± standard deviation and analyzed using the Independent t-test. Qualitative data were presented as numbers and percentages and analyzed using the Chi-square test. Multivariate logistic regression was employed to identify factors associated with the cancer type, and inter-reader agreement among radiologists was evaluated using Kappa statistics. A p-value of < 0.05 was considered statistically significant.
Results: Of the 255 cases, 165 (64.7%) were primary ovarian cancer, and 90 (35.3%) were secondary ovarian cancer. Primary ovarian cancer typically presented as a unilateral mass (67.9%) with a larger size (14.8 ± 5.2 cm) and a mixed solid-cystic pattern (43.6%). In contrast, secondary ovarian cancer commonly appeared as bilateral masses (61.1%) with a smaller size (8.9 ± 3.7 cm) and a predominantly solid pattern (55.5%), along with higher occurrences of peritoneal deposits (80.0%) and lymphadenopathy (72.2%). Significant factors associated with secondary ovarian cancer included peritoneal deposits and lymphadenopathy (OR 6.93), predominantly solid pattern (OR 5.53), and bilateral masses (OR 3.31).
Conclusion: Radiologic characteristics, particularly when considering factors such as laterality, tumor size, tissue composition, and disease spread, can effectively distinguish primary from secondary ovarian cancer.
Keywords: Primary Ovarian Cancer, Secondary Ovarian Cancer, Computed Tomography, Radiologic Diagnosis
References
World Health Organization. Global Cancer Statistics 2024: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2024; 74(1): 23-45.
International Agency for Research on Cancer. Survival trends in ovarian cancer: A global perspective 2024. Lyon: IARC; 2024.
สถาบันมะเร็งแห่งชาติ. สถิติโรคมะเร็งในประเทศไทย พ.ศ. 2566. กรุงเทพฯ: กรมการแพทย์ กระทรวงสาธารณสุข; 2566.
Chen J, Wang X, Li Y, Song K, Zhang M. Risk factors and genetic predisposition in ovarian cancer: A comprehensive review. J Gynecol Oncol 2024; 162(1): 125-34.
Siripongpreeda N, Suprasert P, Wangnararoj T. Changing patterns of ovarian cancer in Thai women: Analysis of age distribution and histological subtypes. Asian Pac J Cancer Prev 2023; 24(8): 2589-96.
สมาคมแพทย์รังสีวิทยาแห่งประเทศไทย. รายงานสถานการณ์กำลังคนด้านรังสีวิทยาในประเทศไทย พ.ศ. 2566. กรุงเทพฯ: สมาคมแพทย์รังสีวิทยาแห่งประเทศไทย; 2566.
Charoenphon P, Siripongpreeda N, Thanakit V. Accuracy of CT interpretation by general practitioners versus radiologists in ovarian mass diagnosis: A multicenter study in Thailand. J Med Assoc Thai 2024; 107(2): 78-85.
กรมการแพทย์ กระทรวงสาธารณสุข. รายงานสถานการณ์มะเร็งในประเทศไทย พ.ศ. 2566: การวิเคราะห์ตามภูมิภาค. กรุงเทพฯ: โรงพิมพ์องค์การสงเคราะห์ทหารผ่านศึก; 2567.
Thanakit V, Siripongpreeda N, Charoenphon P. Inappropriate referral patterns in ovarian cancer: Impact on treatment outcomes in Thailand. Gynecol Oncol Rep 2023; 48: 45-52.
Smith AB, Jones CD, Wilson EF, Brown RH. Distinguishing primary and secondary ovarian malignancies: Current challenges and future directions. Int J Gynecol Cancer 2023; 33(5): 687-96.
Lee YK, Park NH, Kim JW, Song YS, Kang SB, Lee HP. Treatment outcomes and prognostic factors in primary versus secondary ovarian cancer: A systematic review. J Gynecol Oncol 2023; 34(2): 245-57.
Johnson R, Williams P, Anderson K. Treatment strategies for primary and secondary ovarian cancer: A comparative analysis. Gynecol Oncol Res Pract 2024; 11(1): 8-15.
สำนักงานสาธารณสุขจังหวัดอุบลราชธานี. รายงานสถิติการให้บริการโรงพยาบาลสรรพสิทธิประสงค์และเครือข่าย ประจำปีงบประมาณ 2567. อุบลราชธานี: สำนักงานสาธารณสุขจังหวัดอุบลราชธานี; 2567.
กลุ่มงานรังสีวิทยา. รายงานสถิติการตรวจวินิจฉัยด้วยเอกซเรย์คอมพิวเตอร์ในผู้ป่วยมะเร็งรังไข่ ประจำปี 2565-2567. อุบลราชธานี: โรงพยาบาลสรรพสิทธิประสงค์; 2567.
Zhang W, Liu Y, Wang Z, Chen X, Li J, Wu K. Radiological features of primary and secondary ovarian cancer: A diagnostic dilemma. Radiology 2023; 298(3): 442-53.
Kumar A, Patel DR, Singh M. Advanced imaging techniques in differential diagnosis of ovarian masses: A multicenter study. Eur Radiol 2024; 34(1): 178-89.
Thompson DR, Miller RS, Cooper JN, White KL. Role of computed tomography in ovarian cancer staging and treatment planning. AJR Am J Roentgenol 2023; 220(6): 855-67.
Kim HJ, Lee SY, Park BK. CT characteristics of primary versus secondary ovarian cancer: A multicenter study in Asian populations. Korean J Radiol 2023; 24(8): 912-23.
Lee JH, Kim SY, Park B, Cho JY, Kim SH. CT characteristics of secondary ovarian malignancies: a multicenter study. Eur Radiol 2022; 32(8): 5612-21.
Nguyen TH, Le VM, Pham DQ, Tran KL, Hoang NT. Radiological characteristics of ovarian masses in Vietnamese women: A hospital-based study. Asian J Radiol 2024; 31(4): 234-41.
Phommasone K, Sivilay S, Keomalaphet S, Bounxouei B, Sayarath V. Ovarian cancer patterns in Lao PDR: A retrospective analysis. Southeast Asian J Cancer 2023; 15(2): 89-96.
Kim YJ, Lee JS, Choi SH, Park HJ, Yoon JK. Changing trends in ovarian cancer patterns: a 5-year analysis. J Clin Oncol 2024; 42(2): 145-52.
Wang L, Yang M, Chen X. Pathological distribution of ovarian cancers: a systematic review. Int J Gynecol Cancer 2023; 33(4): 512-9.
Chen X, Zhang J, Liu Y. Origin patterns of metastatic ovarian tumors: a global perspective. Gynecol Oncol 2024; 162(1): 78-85.
Park HJ, Kim YS, Lee J. Development and validation of a CT-based diagnostic model for ovarian cancer classification. Korean J Radiol 2022; 23(5): 571-80.
Johnson K, Smith A, Brown B, Wilson C, Taylor M. Diagnostic criteria for ovarian cancer classification. AJR Am J Roentgenol 2023; 220(5): 728-36.
Liu W, Chen H, Wang X, Zhang M, Li J. Metastatic pathways in ovarian cancer: radiological-pathological correlation. Cancer Imaging 2024; 24(1): 12-9.
Martinez RC, Silva AB, Gonzalez MJ, Lopez CT, Rodriguez PH. Impact of misdiagnosis on ovarian cancer treatment outcomes: A systematic review and meta-analysis. Gynecol Oncol 2024; 171(1): 156-64.
Rahman S, Kim HJ, Lee SY, Park BK, Choi MH. Artificial intelligence-assisted diagnosis of ovarian masses using CT imaging: A multicenter validation study. Radiology 2024; 306(2): 445-53.
Downloads
Published
Versions
- 2025-09-23 (2)
- 2025-09-19 (1)
How to Cite
Issue
Section
License
Copyright (c) 2025 YASOTHON MEDICAL JOURNAL
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของยโสธรเวชสาร
