Ultrasound characteristics of early stage high-grade serous ovarian cancer.

Abstract: Background As ovarian cancer survival is strongly dependent on stage at diagnosis, when confronted with a woman with an isolated adnexal mass, clinicians worry about missing an opportunity to detect an early stage cancer. High grade serous ovarian cancers account for 80% of ovarian cancer deaths, largely due to their tendency to be diagnosed at late stage. Among adnexal masses, large size and the presence of solid areas on ultrasound have been found to be associated with cancer, but it is unclear whether these characteristics identify early stage cases. Objective To evaluate the ultrasound findings associated with clinically detected early stage high-grade serous ovarian cancer. Study design Retrospective cohort study of women diagnosed from 2007-2017 with stage I-II high-grade serous ovarian or fallopian tube cancer measuring at least 1 cm at pathology. Preoperative ultrasounds were independently reviewed by 3 radiologists. Adnexal masses were scored for size and volume; overall appearance; presence, thickness and vascularity of septations; morphology and vascularity of other solid components; and degree of ascites. Characteristics were compared between masses Results Among 111 women identified, 4 had bilateral ovarian involvement, for a total of 115 adnexal masses characterized by ultrasound. The mean age at diagnosis was 61.8 years (range 42-91 years). Median mass size was 9.6 cm (range 2.2-23.6 cm) with 87% being > 5 cm. A mixed cystic and solid appearance was most common (77.4%) but a completely solid appearance was more frequently seen for tumors Conclusions In this community-based cohort, early stage high-grade serous cancers rarely presented as masses