Identification of factors that impact recurrence in patients with borderline ovarian tumors

Chen, Xi; Fang, Chenyan; Zhu, Tao; Zhang, Ping; Yu, Ao; Wang, Shihua

doi:10.1186/s13048-017-0316-5

Cited by 26 publications

(25 citation statements)

References 42 publications

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“…The safety of ipsilateral ovarian reservation for BOTs has been seldom evaluated in the literature. Ovarian cystectomy to spare the ipsilateral ovary/ovaries improved the risk of recurrence [ 2 , 15 , 31 , 32 ], consistent with our findings. However, this procedure had no significant impact on OS in patients with BOTs.…”

Section: Discussionsupporting

confidence: 89%

“…For BOTs, consensus has also not been reached on the indications and roles of adjuvant chemotherapy. This treatment method has not been identified in this study or in previous studies as a significant favorable factor for the prognosis of patients with BOTs [ 15 , 26 ]. Trope et al [ 37 ] demonstrated that adjuvant therapy showed no prognostic benefit but had serious toxicity.…”

Section: Discussionmentioning

confidence: 77%

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The safety of fertility and ipsilateral ovary procedures for borderline ovarian tumors

et al. 2017

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ObjectiveTo explore the optimal treatment options for women with borderline ovarian tumors (BOTs).Materials and MethodsThe medical records of consecutive patients with BOTs in two academic institutions were retrospectively collected. The pertinent data, including clinicopathological characteristics and, treatment and prognostic information were evaluated.ResultsA total of 281 cases of BOTs were included in this analysis. For the entire series, the 5- year disease-free survival (DFS) and overall survival (OS) rates were 91.8% and 98.5%, respectively. In the multivariate analysis, reservation of the ipsilateral ovary (HR: 0.104 [95% CI, 0.036–0.304], p = 0.000) and FIGO stage II–III (HR: 6.811 [95% CI, 2.700–17.181], p = 0.000) were the independent risk factors for recurrence. Ovarian surface involvement (HR: 64.996 [95% CI, 4.054–1041.941], p = 0.003) was the only independent prognostic factor for OS. Lymphadenectomy and adjunct chemotherapy had no significant impact on patients’ recurrence and survival (recurrence: p = 0.332 and 0.290, respectively, survival: p = 0.896 and 0.216, respectively).ConclusionsFertility-sparing surgery with healthy ovarian preservation seems safe and feasible for young women who prefer fertility-sparing treatment. Ovarian cystectomy to conserve the affected ovary/ovaries without ovarian surface involvement may be cautiously performed under fully informed consent for young women with bilateral BOTs who strongly prefer fertility-sparing treatment and have no evidence of infertility. However, long-term follow-up is necessary due to the relapse susceptibility of the ovary.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 77%

The safety of fertility and ipsilateral ovary procedures for borderline ovarian tumors

et al. 2017

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“…Those with an elevated baseline of CA-125 had a 87% PFS at 3 years and those with a normal baseline of CA-125 had a 97% PFS at 3 years. 20,22,23 Another important prognostic factor for serous BOTs is the presence of micropapillary patterns, which has a 3 year PFS rate of 76%, compared to the absence of micropapillary patterns, which has a 3 year PFS of 94%. 20,[24][25][26]…”

Section: Discussionmentioning

confidence: 99%

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

Rezai¹,

Àlex²,

Hughes³

et al. 2018

OGIJ

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Background: Ovarian cancer represents approximately 30% of all female reproductive organ cancers and is the leading cause of death for gynecological cancer in the United States. Borderline ovarian tumors comprise approximately 15-20% of all epithelial ovarian tumors and within that group, serous borderline ovarian tumors comprise 53%. Serous borderline tumors (SBT) display atypical epithelial proliferation of serous type cells, outnumbering benign epithelial cells but have a low malignancy potential (borderline). By definition SBT has no gross stromal invasion but it can be subcategorized to those with or without microinvasion. Carcinomas make up 90% of ovarian tumors and differentiating between the distinct types of tumors via unique features is important for treatment. Case:The patient was a 29-year-old G0P0, who presented to our clinic for evaluation of intermenstrual bleeding. Upon physical exam, a palpable, 5cm x 4cm non-tender, mobile mass in the right adnexa was noted. Pelvic ultrasound revealed a 4.9cm x 3.7cm hypoechoic mass in the right adnexa. The mass was noted to be heterogeneous with smooth borders and a preliminary diagnosis of ovarian cystadenoma was made. The patient in this case presented with a stage 1C2 ovarian cancer and was treated with single incision laparoscopic surgery (SILS) right salpingo-oophorectomy. Conclusion:Ovarian cancer is the leading cause of gynecological cancers in women in the US and early diagnosis/staging is important in predicting progression-free survival. Instead of laparotomy, we utilized single-incision laparoscopic surgery to drain the patient's pelvic effusion and excise the right ovary and fallopian tube, which revealed an ovarian borderline serous tumor. This technique was conservative and fertility-sparing because it left the uterus, left ovary and left fallopian tube.

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“…Stage T1 defined in AJCC 3rd is the same as stage I in FIGO 2014, except that stage Ic in FIGO 2014 is further divided into Ic1, Ic2 and Ic3 stages. The inclusion and exclusion criteria for these patients has been described previously [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

“…Current consensus states that fertility preserving surgery is associated with an increased risk of recurrence [ 8 – 12 ]. Data from ours and other groups showed that certain styles of fertility preserving surgery may have a higher risk of recurrence than the others [ 13 – 15 ]. However, fertility preserving surgery was not shown to compromise overall survival in these patients [ 16 – 19 ].…”

Section: Introductionmentioning

confidence: 93%

Age-dependent difference in impact of fertility preserving surgery on disease-specific survival in women with stage I borderline ovarian tumors

et al. 2018

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BackgroundThis study was to determine age-specific impact of fertility preserving surgery on disease-specific survival in women with stage I borderline ovarian tumors (BOTs). Patients diagnosed during 1988–2000 were selected from The Surveillance, Epidemiology, and End Results (SEER) database. The age-specific impact of fertility preserving surgery and other risk factors were analyzed in patients with stage I BOTs using Cox proportion hazard regression models. Data from our hospital were collected during 1996–2017 to determine the prevalence of patients who had undergone fertility preserving surgery.ResultsOf a total 6295 patients in the SEER database, this study selected 2946 patients with stage T1 BOTs who underwent fertility preserving or radical surgery. Their median age at diagnosis was 45.0 years and the median follow-up time was 200 months. Fertility preserving surgery was performed in 1000/1751 (57.1%) patients < 50 years and in 1,81/1195 (15.1%) patients ≥50 years. Fertility preserving surgery was significantly associated with worse disease-specific survival only in patients ≥50 years. Increased age, stage T1c and mucinous histology were risk factors for overall patients or patients ≥50 years, but not for < 50 years. Data from our hospital showed that fertility preserving surgery was performed in 53.9 and 12.3%patients < 50 and ≥ 50 years with stage I disease, respectively.ConclusionFertility preserving surgery is safe for women < 50 years with early staged BOTs, but it may decrease disease-specific survival in patients ≥50 years. Conservative surgery is performed at a relatively high rate in patients ≥50 years.Electronic supplementary materialThe online version of this article (10.1186/s13048-018-0423-y) contains supplementary material, which is available to authorized users.

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Identification of factors that impact recurrence in patients with borderline ovarian tumors

Cited by 26 publications

References 42 publications

The safety of fertility and ipsilateral ovary procedures for borderline ovarian tumors

The safety of fertility and ipsilateral ovary procedures for borderline ovarian tumors

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

Age-dependent difference in impact of fertility preserving surgery on disease-specific survival in women with stage I borderline ovarian tumors

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