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Managing Liver Metastases With Ovarian Cancer

Medically Reviewed by Laura J. Martin, MD on July 19, 2022

Ovarian cancer is a cancer that starts in your ovaries or fallopian tubes. Sometimes, the cancer stays there. Other times, it spreads to nearby organs like your liver. When that happens, it’s called metastasis.

What Are Stage III and Stage IV Ovarian Cancer?

Stage III ovarian cancer is when the cancer is not just found in one or both ovaries, but has spread outside the pelvis to the abdomen, nearby lymph nodes, or the surface of your liver.

About 60% of all ovarian cancer cases are diagnosed at this stage. The 5-year survival rate is about 75%.

In stage IV ovarian cancer, your cancer has spread beyond your abdomen to other organs like your lungs or inside your liver. The 5-year survival rate is 31%.

What Are the Symptoms of Ovarian Cancer That’s Spread to Your Liver?

Ovarian cancer often has no symptoms, which is why it may not be caught until later stages. Those signs include:

  • Bloating
  • Pelvic or belly pain
  • Feeling full quickly or after you eat a small amount of food
  • Peeing a lot or feeling like you always have to pee

Many women experience these types of symptoms occasionally. But if you have ovarian cancer, they will occur more frequently and be more severe. See your doctor if you notice any of these symptoms more than a dozen times in a month.

Other symptoms to watch for include:

  • Extreme fatigue
  • Upset stomach
  • Back pain
  • Pain during sex
  • Constipation
  • Unexplained weight loss
  • Period changes (heavy bleeding or irregular bleeding)

How Is Ovarian Cancer That’s Spread to Your Liver Diagnosed?

If your doctor suspects ovarian cancer, they will do more evaluations like:

  • Pelvic exam. This checks if your ovaries are enlarged or there’s any signs of a pelvic mass or fluid in your abdomen.
  • Transvaginal ultrasound. This is usually the first imaging test performed to check for ovarian cancer. It’s done vaginally, to check whether a suspected mass is solid or fluid filled.
  • CA-125 blood test. This measures the amount of a protein called CA-125. It’s usually elevated in women with ovarian cancer. It’s also often used during treatment to gauge if therapy is working.
  • CT scan. This helps your doctor figure out if your ovarian cancer has spread to other parts of your body. It’s a good way to find large tumors and to find out if they are growing into other organs like your abdomen or liver.

If it appears that you have ovarian cancer, your doctor will do surgery to make a definitive diagnosis and remove the tumor. Your doctor may then run the following tests to determine if it’s spread to other parts of your body, including your liver:

  • MRI scan. This test can help evaluate abnormal liver findings. It is also helpful to check to see if the cancer has spread to your spine or brain.
  • PET scan. You’ve given an injection of radioactive glucose, a type of sugar, to look for cancer. Cancer cells are more likely to gobble up this sugar than healthy ones. A special camera takes pictures to show areas of radioactivity in your body. This will help your doctor figure out where exactly your cancer has spread, including whether it’s on the surface or in your liver.

If it looks like the cancer has spread to your liver, your doctor may want to biopsy it. They will do a procedure called a CT-guided needle biopsy, where they use a CT scan to pinpoint the mass so that the radiologist can reach it and biopsy it with a needle. A small amount of tissue is removed and examined in a lab.

How Is Ovarian Cancer That’s Spread to Your Liver Treated?

If you are diagnosed with stage III or stage IV ovarian cancer, your doctor will most likely recommend the following treatment:

Surgery. Your doctor will remove as much of the cancer as possible. This usually involves taking out your uterus, fallopian tubes, and ovaries. Since your cancer has spread beyond this area, your doctor may also need to take out other parts of organs, including a part of your liver. This is known as tumor debulking, or cytoreduction. The goal is to remove as much cancerous tissue as possible to boost the effectiveness of follow-up chemotherapy.

Several studies have followed patients with ovarian cancer that had spread to their liver and found that those who had the cancerous parts of their liver removed survived more than twice as long as those who didn’t (around 50 months vs. 20 months). You’ll generally need to stay in the hospital about a week after the surgery, and you'll be able to resume normal activities within 4 to 6 weeks.

Chemotherapy. This may be recommended either before or after surgery to destroy cancer cells that have spread to other parts of your body, including your liver. Typically, your doctor will use a specific combination of chemotherapy medicines. It could be a combination of a platinum-type drug, like carboplatin, and a taxane-type drug such as paclitaxel. These have been shown to be the most successful in the treatment of ovarian cancer.

What Is the Prognosis of Ovarian Cancer That’s Spread to Your Liver?

If you’re diagnosed in stage III, you have a 70% to 90% chance of recurrence. If you’re diagnosed in stage IV, that rises to 90% to 95%.

If your cancer does return to your liver, your doctor may recommend that you have surgery again to remove it. This is controversial, but there is some research to suggest it does improve your prognosis. You are more likely to benefit if:

  • Your surgeon is able to remove all of the cancer.
  • There’s more cancer in your pelvis than your abdomen.
  • There’s been at least a year from your original diagnosis.

You may also undergo additional rounds of chemotherapy. It’s important to talk to your doctor about the risks and benefits of these treatments. You may decide that continuing is not likely to improve your health and may impact your quality of life. This is a very personal decision, and one you have to make on your own.

Show Sources

SOURCES:

American Cancer Society: “If You Have Ovarian Cancer,” Signs & Symptoms of Ovarian Cancer,” “Tests for Ovarian Cancer,” “Treatment for Ovarian Cancer.”

Ovarian Cancer Research Alliance: “About Ovarian Cancer: Staging,” “About Ovarian Cancer: Recurrence.”

Dana Farber Cancer Institute: “How We Diagnose Ovarian Cancer.”

UpToDate: “Treatment of Ovarian Cancer: Beyond the Basics,” “Cancer of the Ovary Fallopian Tube and Peritoneum Surgical Options for Recurrent Cancer.”

Memorial Sloan Kettering Cancer Center: “Surgery for Ovarian Cancer.”

World Journal of Hepatology: “Addressing Hepatic Metastases in Ovarian Cancer.”

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