Email this article Prognostic significance of ascites, the presence of tumor cells in ascitic fluid, and the state of the tumor capsule in early ovarian cancer: a retrospective analysis
- Authors: Abduragimova Z.T.1, Kulikova S.E.1, Selchuk V.Y.2, Grebennikova O.P.2, Мaslennikova А.V.3, Nechushkina V.M.3,4
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Affiliations:
- Moscow City Cancer Hospital No. 62, Moscow Healthcare Department
- Russian University of Medicine, Ministry of Health of Russia
- Privolzhsky Research Medical University, Ministry of Health of Russia
- Scientific and Educational Center “Eurasian Oncology Program”
- Issue: Vol 22, No 1 (2026)
- Pages: 53-60
- Section: GYNECOLOGY. ORIGINAL REPORTS
- Published: 02.07.2026
- URL: https://ojrs.abvpress.ru/ojrs/article/view/1474
- DOI: https://doi.org/10.17650/1994-4098-2026-22-1-53-60
- ID: 1474
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Abstract
Background. Ovarian cancer (OC) has a high mortality rate, which makes the study of prognostic factors at early stages relevant. Intraoperative tumor capsule rupture and the presence of tumor cells in ascites / peritoneal washings are considered potentially significant outcome predictors.
Aim. To evaluate the impact of tumor capsule rupture, ascites, and tumor cells in peritoneal fluid on overall survival (OS) and progression-free survival (PFS) in patients with stage I–II OC.
Materials and methods. A retrospective analysis of data from 209 patients with stage I–II OC (FIGO, 2016) treated between 1990 and 2019 was conducted. Tumor capsule rupture was detected in 67 (32.0 %) patients, ascites – in 25 (12.0 %) patients. Cytological examination of ascitic fluid or peritoneal washings was performed in 80 patients; tumor cells were found in 29 (36.3 %) of them. Statistical analysis was performed using the Kaplan–Meier method, log-rank test, and Cox regression.
Results. Tumor capsule rupture was associated with a statistically significant decrease in survival rates: 5-year OS was 66.8 % vs. 87.6 % (p = 0.032), and 5-year PFS was 53.1 % vs. 73.4 % (p = 0.037) in groups with and without tumor capsule rupture, respectively. The hazard ratio (HR) for OS was 0.61 (95 % confidence interval (CI) 0.39–0.96). The presence of ascites did not show a significant effect on OS (HR 1.11; 95 % CI 0.70–1.77) and PFS (HR 0.96; 95 % CI 0.65–1.42). The detection of tumor cells in peritoneal fluid significantly worsened PFS: 5-year PFS was 63.1 % vs. 85.7 % (p = 0.020) in case of their presence and absence, respectively (HR 2.49; 95 % CI 0.86–7.21).
Conclusion. Tumor capsule rupture and the presence of tumor cells in ascitic fluid / peritoneal washings are significant adverse prognostic factors in patients with stage I–II OC. The obtained data emphasize the importance of a careful surgical approach to prevent tumor capsule rupture and the necessity of a thorough cytological examination of ascitic fluid and peritoneal washings to determine the risk of death and progression in stage I–II OC.
About the authors
Zarema T. Abduragimova
Moscow City Cancer Hospital No. 62, Moscow Healthcare Department
Author for correspondence.
Email: zarremsa@yandex.ru
Russian Federation, 27 Istra Settlement, Moscow Region 143423
S. E. Kulikova
Moscow City Cancer Hospital No. 62, Moscow Healthcare Department
Email: zarremsa@yandex.ru
Russian Federation, 27 Istra Settlement, Moscow Region 143423
V. Yu. Selchuk
Russian University of Medicine, Ministry of Health of Russia
Email: zarremsa@yandex.ru
Russian Federation, 4 Dolgorukovskaya St., Moscow 127006
O. P. Grebennikova
Russian University of Medicine, Ministry of Health of Russia
Email: zarremsa@yandex.ru
Russian Federation, 4 Dolgorukovskaya St., Moscow 127006
А. V. Мaslennikova
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: zarremsa@yandex.ru
Russian Federation, 10 / 1 Ploshchad Minina i Pozharskogo, Nizhny Novgorod 603950
V. M. Nechushkina
Privolzhsky Research Medical University, Ministry of Health of Russia; Scientific and Educational Center “Eurasian Oncology Program”
Email: zarremsa@yandex.ru
ORCID iD: 0000-0002-1855-9692
Russian Federation, 10 / 1 Ploshchad Minina i Pozharskogo, Nizhny Novgorod 603950; Build. 1, 1 Volokolamskoe Shosse, Moscow 125080
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