Borderline tumors of the ovary: A clinicopathological study

Abstract

Objective:To report experience with borderline ovarian tumors (BOTs) in a developing country like Pakistan with limited resources and weak database of health system.Methods:Patients with BOTs managed at Shaukat Khanum Cancer hospital, Lahore, Pakistan from 2004 to 2014 were included and reviewed retrospectively. Data was recorded on histopathological types, age, CA-125, stage of disease, treatment modalities and outcomes.Results:Eighty-six patients with BOT were included with a median age of 35 years. Forty-two (49%) patients had serous BOTs and 43 (50%) had mucinous BOTs, while one (1%) had mixed type. Using FIGO staging, 80 patients had stage I; two patients had IIA, IIB and stage III each. Median follow-up time was 31.5 months. All patients had primary surgery. Seventy (81%) patients underwent complete surgical resection of tumor. Forty-three (50%) patients had fertility preserving surgery. Seventy-three (85%) patients remained in remission. Recurrent disease was observed in 13 (15%) patients. Median time to recurrence was 22 months. On further analysis, age above forty years, late stage at diagnosis and incomplete surgery were significantly associated with invasive recurrence.Conclusion:Despite a low malignant potential, relapses may occur in patients above forty years of age, incomplete surgery and staging information and advanced stage at presentation. Fertility sparing surgery should be considered in young patients. Complete excision of tumor and prolonged follow-up are advised because recurrence and transformation to invasive carcinoma may occur.

Malignant Transformation of a Borderline Ovarian Tumor With Pulmonary and Pleural Metastases After Years of Latency: A Case Report and Literature Review

“…Recurrence rates vary in different studies ( 1 ). A systematic review ( 6 ) showed that 37% of recurrences are diagnosed during the first 2 years, 31% in years 2–5, and 32% more than 5 years after diagnosis, including 10% after more than 10 years.…”

“…Thus, evaluation of the nodule size, which might be related to BOTs according to the RECIST (Response Evaluation Criteria in Solid Tumors) guideline ( 9 ), may be helpful to monitor malignant transformation or malignancy recurrence. In one retrospective review, age ≥40 years, a late stage at diagnosis and incomplete surgery were significantly associated with invasive recurrence, while complete tumor excision and a prolonged follow-up were advised for cases in which malignant transformation may occur ( 1 ).…”

“…Histopathologically, the behavior of this group of neoplasms is intermediate between the behavior of benign cystadenomas and invasive carcinomas; however, the morphological changes are diverse, and the behavior is therefore heterogenous. The serous and mucinous subtypes are the most common forms (1). Although BOTs have a favorable prognosis, an advanced FIGO stage, recurrence, and malignant transformation are critical factors affecting the prognosis.…”

Laparoendoscopic single-site oophorectomy for a right ovarian borderline serous tumor of stage IC2, a literature review

“…Recently more studies have attempted to quantify the success of fertility after conservative surgery. 12 This should be considered and discussed with the patient prior to treatment and may include fertility counseling.…”

Dysregulated Immunological Functionome and Dysfunctional Metabolic Pathway Recognized for the Pathogenesis of Borderline Ovarian Tumors by Integrative Polygenic Analytics

“…In contrast, MBOTs, approximately 32% of BOTs [ 8 ], occur predominately in East Asia and parts of Europe [ 9 ]. BOTs are predominantly diagnosed in premenopausal females before the age of 40 and are rarely confirmed in older women after the age of 65 [ 10 , 11 , 12 ].…”