Clinical behavior of borderline ovarian tumors: A study of 150 cases

Koji, Takehiko; Kikkawa, Fumitaka; Nakashima, Naoki; Tamakoshi, Akiko; Kawai, Michiyasu; Furuhashi, Yoshihito; Hattori, Shinobu; Kuzuya, Kazuo; Arii, Yoshitaro; Suganuma, Nobuhiko; Tsutsumi, Yutaka

doi:10.1002/(sici)1096-9098(199702)64:2<147::aid-jso11>3.0.co;2-3

Cited by 39 publications

(20 citation statements)

References 19 publications

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“…There is molecular and pathologic evidence that there is a progression of mucinous cystadenomas to an LMP tumor before developing into an advanced adenocarcinoma. Advanced-stage disease display aggressive, chemoresistant behavior with patients demonstrating a shorter median survival rate (28). This contrasts to other ovarian cancer histologic types, such as papillary serous.…”

Section: Discussionmentioning

confidence: 99%

Expression Profiling of Mucinous Tumors of the Ovary Identifies Genes of Clinicopathologic Importance

Wamunyokoli

Bonome

Lee³

et al. 2006

Clinical Cancer Research

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Purpose: To elucidate the molecular mechanisms contributing to the unique clinicopathologic characteristics of mucinous ovarian carcinoma, global gene expression profiling of mucinous ovarian tumors was carried out. Experimental Design: Gene expression profiling was completed for 25 microdissected mucinous tumors [6 cystadenomas, 10 low malignant potential (LMP) tumors, and 9 adenocarcinomas] using Affymetrix U133 Plus 2.0 oligonucleotide microarrays. Hierarchical clustering and binary tree prediction analysis were used to determine the relationships among mucinous specimens and a series of previously profiled microdissected serous tumors and normal ovarian surface epithelium. PathwayAssist software was used to identify putative signaling pathways involved in the development of mucinous LMP tumors and adenocarcinomas. Results: Comparison of the gene profiles between mucinous tumors and normal ovarian epithelial cells identified 1,599, 2,916, and 1,765 differentially expressed in genes in the cystadenomas, LMP tumors, and adenocarcinomas, respectively. Hierarchical clustering showed that mucinous and serous LMP tumors are distinct. In addition, there was a close association of mucinous LMP tumors and adenocarcinomas with serous adenocarcinomas. Binary tree prediction revealed increased heterogeneity among mucinous tumors compared with their serous counterparts. Furthermore, the cystadenomas coexpressed a subset of genes that were differentially regulated in LMP and adenocarcinoma specimens compared with normal ovarian surface epithelium. PathwayAssist highlighted pathways with expression of genes involved in drug resistance in both LMP and adenocarcinoma samples. In addition, genes involved in cytoskeletal regulation were specifically up-regulated in the mucinous adenocarcinomas. Conclusions:These data provide a useful basis for understanding the molecular events leading to the development and progression of mucinous ovarian cancer.Epithelial ovarian cancer is the fourth leading cause of cancer deaths in women in the United States (1). An estimated 22,220 new cases of this malignancy will be diagnosed, and f16,210 deaths attributed to this disease in the United States during 2005 (1). This high case fatality rate is due in part to the fact that the majority of patients (75%) are diagnosed after extraovarian spread of the disease has occurred. The 5-year survival rate for women with the late-stage disease is 25% compared with a rate of >90% for women with early-stage (2, 3).The histologic classification of ovarian carcinomas is based on morphologic criteria and corresponds to the different types of epithelia in the female reproductive system, including papillary serous, mucinous, endometrioid, clear cell, and Brenner (transitional; ref. 4). Each class has been further subclassified into benign, malignant, and borderline or low malignant potential (LMP) to reflect their histopathology. Mucinous ovarian tumors account for 12% to 15% of all ovarian neoplasms. The majority of mucinous ovarian tumors are beni...

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Section: Discussionmentioning

confidence: 99%

Expression Profiling of Mucinous Tumors of the Ovary Identifies Genes of Clinicopathologic Importance

Wamunyokoli

Bonome

Lee³

et al. 2006

Clinical Cancer Research

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“…In 1961, the Cancer Committee of the International Federation of Gynecology and Obstetrics (FIGO) proposed a classification of common primary epithelial ovarian tumors which was adopted in 1970 and became effective on January 1, 1971. 6 In the FIGO classification, the common primary epithelial tumors were subdivided into three groups: benign cystadenoma; cystadenoma with proliferating activity of the epithelial cells and nuclear abnormalities, but with no infiltrative destructive growth (low potential malignancy); and, cystadenocarcinoma. combined classification of the International Society of Gynecologic Pathologists and the WHO.…”

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confidence: 99%

Borderline epithelial tumors of the ovary

2005

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The concept and terminology of borderline epithelial tumors of the ovary have been controversial for over a century, in spite of the acceptance of a borderline category in almost all current classifications of ovarian tumors. Typically, borderline tumors are noninvasive neoplasms that have nuclear abnormalities and mitotic activity intermediate between benign and malignant tumors of similar cell type. Borderline tumors of all surface epithelial cell types have been studied. The most common and best understood are serous borderline tumors and mucinous borderline tumors of intestinal type, which are the subject of this review. Some of the most challenging issues for serous tumors include: the criteria and clinical behavior of stromal microinvasion; the high prevalence of synchronous extraovarian disease; the classification and histopathologic features of associated peritoneal tumor implants, especially invasive implants; and, the prognostic significance of micropapillary tumors. The mucinous borderline tumors of intestinal type have a different set of considerations, including: their frequently heterogeneous composition with coexisting benign, borderline and malignant elements; the classification and significance of accompanying noninvasive carcinoma; the recognition of stromal invasion, including microinvasion and expansile invasion; and, the historically misunderstood relationship to pseudomyxoma peritonei. All of these issues are discussed in this presentation, as are the important gross and microscopic features of serous and mucinous borderline tumors and pertinent information on their treatment and prognosis. Modern Pathology (2005) 18, S33-S50.

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“…However, gynaecologic oncologists have long sought prognostic markers that could help to assess accurately the postoperative progression risk in mucinous LMP patients, because a subset of these tumours can progress and become lethal. For advanced stage mucinous LMPs, earlier detection of a recurrence may not always result in improved prognosis, due to the lack of efficacious chemotherapy (Tamakoshi et al, 1997). However, in patients with early-stage tumours who have been treated primarily with conservative surgery, earlier detection of recurrence may result in better prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Serous and mucinous tumours comprise the vast majority of cases, with endometrioid, clear cell, and Brenner-type tumours also described (Russel et al, 1994). Low malignant potentials (30 -50%) are mucinous type (Lee and Scully, 2000) and the incidence of mucinous LMPs is high in Japan compared to Western countries (Nakashima et al, 1990;Tamakoshi et al, 1997).…”

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confidence: 99%

Allelic loss at 19q12 and Xq11–12 predict an adverse clinical outcome in patients with mucinous ovarian tumours of low malignant potential

et al. 2004

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Ovarian tumours of low malignant potential (LMP) are intermediate between adenomas and ovarian carcinomas. These tumours are often associated with a significantly better prognosis than ovarian carcinomas. However, a subset of these tumours can progress and become lethal. In order to seek sensitive diagnostic tools for monitoring patients after surgical operation, we performed a genomewide scan for loss of heterozygosity (LOH) in 41 mucinous LMPs using 91 polymorphic microsatellite markers at an average interval of 50 cM across all of the human chromosomes and 25 LOH markers reportedly associated with ovarian carcinoma. In addition, we assessed whether clinicopathological parameters, microvessel density, Ki-67 labeling index, apoptotic index or p53 overexpression would be useful for predicting the postoperative outcome of LMP patients. Of the 116 markers examined, 19q12 and Xq11 -12 showed significant correlation between postoperative progression-free survival time and LOH status (Po0.05). Patients with a high Ki-67 labeling index had a significantly poorer progression-free survival time than those with lower levels (P ¼ 0.042). Other clinicopathological factors and immunohistochemical analysis had no correlation with progression-free survival time in this series of patients. When the combination of LOH at 19q12 and/or Xq11 -12 was assessed using Cox's regression analysis, patients with tumours that showed LOH at these positions were at greatest risk of progression (P ¼ 0.0073). These findings suggest that the identification of LOH at 19q12 and/or Xq11 -12 in former mucinous LMP sites should alert the clinician to the presence of a potentially aggressive lesion in the coelomic epithelium, even if a distinction between second primary tumours or recurrence could not be determined.

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Clinical behavior of borderline ovarian tumors: A study of 150 cases

Cited by 39 publications

References 19 publications

Expression Profiling of Mucinous Tumors of the Ovary Identifies Genes of Clinicopathologic Importance

Expression Profiling of Mucinous Tumors of the Ovary Identifies Genes of Clinicopathologic Importance

Borderline epithelial tumors of the ovary

Allelic loss at 19q12 and Xq11–12 predict an adverse clinical outcome in patients with mucinous ovarian tumours of low malignant potential

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