Surgery as sole treatment for serous borderline tumors of the ovary with noninvasive implants

Lackman, F; Carey, Mark; Kirk, Mary Ellen; McLachlin, C. Meg; Elit, Laurie

doi:10.1016/s0090-8258(03)00331-7

Cited by 29 publications

(20 citation statements)

References 34 publications

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“…It has an incidence of 4.8/100,000 per year (3), and an excellent clinical outcome reflected by 10-year survival rates of ;90% (4). Recurrence rates according to the literature vary between 8% and 32% (5)(6)(7)(8)(9). Few studies have analyzed risk factors for disease recurrence or prognosis (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Predictive value of CA 125 and CA 72-4 in ovarian borderline tumors

Lenhard

Nehring

Nagel

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: The aim of this study was to assess the prognostic value of cancer antigen (CA) 125 and CA 72-4 in patients with ovarian borderline tumor (BOT). Methods: All women diagnosed and treated for BOT at our institution between 1981 and 2008 were included into this retrospective study (ns101). Preoperatively collected serum samples were analyzed for CA 125 (Architect, Abbott and Elecsys, Roche) and CA 72-4 (Elecsys, Roche) with reference to clinical data and compared to healthy women (ns109) and ovarian cancer patients (ns130). Results: With a median of 34.7 U/mL (range 18.1-385.0 U/mL) for CA 125 and 2.3 U/mL (range 0.2-277.0 U/mL) for CA 72-4, serum tumor markers in BOT patients were significantly elevated as compared to healthy women with a median CA 125 of 13.5 U/mL (range 4.0-49.7 U/mL) and median CA 72-4 of 0.8 U/mL (range 0.2-20.6 U/mL). In addition, there was a significant difference compared with ovarian cancer patients who showed a median CA 125 of 401.5 U/mL (range 12.5-35,813 U/mL), but no difference was observed for CA 72-4 (median 3.9 U/mL, range 0.3-10,068 U/mL). Patients with a pT1a tumor stage had significantly lower values of CA 125 but not of CA 72-4 compared with individuals with higher tumor stages (median CA 125 29.9 U/mL for pT1a vs. 50.9 U/mL for )pT1a; ps0.014). There was a trend for increased concentrations of CA 125 but not of CA 72-4 in the presence of ascites, endometriosis or peritoneal implants at primary diagnosis. With respect to the prognostic value of CA 125 or CA 72-4, CA 125

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Section: Introductionmentioning

confidence: 99%

Predictive value of CA 125 and CA 72-4 in ovarian borderline tumors

Lenhard

Nehring

Nagel

et al. 2009

Clinical Chemistry and Laboratory Medicine

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“…Omental metastases are common with both invasive and non-invasive peritoneal implants associated with ovarian borderline tumors. Of 16 patients with ovarian borderline tumors and non-invasive peritoneal implants reported by Lackman et al, 12 had metastases to the omentum, but after 5 years mean follow-up (range 2 months to 11.2 years), only two of the patients in their series had developed recurrent disease, and all of these women were living at the time of their report [80]. With a longer mean follow-up of 10.3 years, Gershenson and colleagues reported 30% recurrences in 73 patients with ovarian borderline tumor and non-invasive peritoneal implants, and 31% of 39 patients with ovarian borderline tumors and invasive peritoneal implants had recurred during a mean follow-up of 9.3 years [74,75].…”

Section: Pathological Considerationsmentioning

confidence: 90%

“…While substantial numbers of borderline ovarian tumors associated with invasive and aggressive peritoneal carcinomatosis and also apparent transformation of borderline peritoneal implants and borderline primary peritoneal tumors to invasive carcinoma have been reported [65,66,[68][69][70][71][72][73][74][75][76][77][78][79][80], recent observations tend to disassociate HBOC syndrome and BRCA1 and BRCA2 mutation carriers from increased risk for borderline ovarian tumors [81][82][83][84][85]. Risch et al found no BRCA1 or BRCA2 mutations in 134 women with borderline ovarian tumors diagnosed in Ontario, Canada; whereas, 11.7% of 515 woman diagnosed with invasive ovarian cancers carried either BRCA1 or BRCA2 mutations [86].…”

Section: Pathological Considerationsmentioning

confidence: 99%

Peritoneal carcinoma in women with genetic susceptibility: implications for Jewish populations

Casey

Bewtra

2004

Familial Cancer

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Women from families with multiple cases of breast and ovarian cancer, specifically those who carry cancer-associated mutations of BRCA1 or BRCA2 are at increased life-time risk for peritoneal carcinoma, even after previous surgery to remove the ovaries, fallopian tubes and uterus. Hereditary breast-ovarian cancer (HBOC) syndrome and the associated BRCA1 and BRCA2 mutations are particularly prevalent in women of Jewish lineage, and specific BRCA1 and BRCA2 germline mutations have been linked with peritoneal carcinoma and HBOC syndrome in Jewish populations, especially those of Ashkenazi descent. This review presents the currently available data and looks forward toward further and better understanding of peritoneal carcinoma in women with inherited susceptibility. Over 90% of peritoneal cancer in patients from HBOC syndrome kindreds and associated with BRCA1 and BRCA2 mutations are serous carcinomas, which is equivalent with the proportion of ovarian cancers that are serous carcinomas in similar patients. The best indications are that while many peritoneal carcinomas in genetically susceptible women may arise directly from malignant transformation of the peritoneum, others might represent metastases from primary ovarian or fallopian tube carcinomas. Although the incidence of borderline ovarian tumors may not be increased in HBOC syndrome kindreds and those who carry cancer-associated BRCA1 and BRCA2 mutations, these individuals could be susceptible to malignant transformation of borderline lesions of the ovaries and peritoneum. Moreover, recent reports raise the question of possibly increased risk in Jewish carriers of germline BRCA1 mutations for uterine papillary serous carcinoma, which could be the source of metastasis to the peritoneum in some cases. The penetrance of cancer-associated BRCA1 mutations for ovarian cancer is estimated to be 11%-54%, and for BRCA2 mutations the penetrance for ovarian cancer is 11%-23%. So far, available screening methods appear to be insufficient for early detection of many ovarian cancers. Prophylactic oophorectomy has been found to reduce the risk for ovarian cancer in women from HBOC kindreds and those who carry cancer-associated BRCA1 and BRCA2 mutations, leaving a residual risk for peritoneal carcinomatosis of well less than 5%. Therefore, surgical removal of the ovaries, fallopian tubes and uterus, after child-bearing has been completed and by early in the fifth decade of life, are appropriate prophylactic procedures in women whose genetic susceptibility puts them at increased risk for cancers of mullerian tract origin, including ovarian and fallopian tube carcinomas and possibly serous carcinoma of the uterus. Hysterectomy, as well as salpingo-oophorectomy, removes the gynecologic organs targeted for malignant transformation in genetically susceptible women and simplifies decisions regarding hormone replacement therapy and chemical prophylaxis and treatment of breast cancer. Unless a transabdominal operative approach is otherwise indicated, laparoscopic-assisted transvagin...

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“…44 Chemotherapy generally has little effect on these slow-growing tumors. Thus, there is no prospective data to suggest that either adjuvant chemotherapy or radiation therapy improve survival.…”

Section: Adjuvant Therapymentioning

confidence: 99%

Borderline ovarian tumors

Ghaemmaghami¹,

Ashraf-Ganjooie

Iravanloo

2007

Asia-Pac J Clncl Oncology

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Borderline ovarian tumors account for approximately 15% of all epithelial ovarian tumors. In the early 1970s, borderline tumors were categorized as either serous or mucinous with overall survival rates of 75-90%. Since then, it has been recognized that the two categories are heterogonous. There are now many different groups following the recognition of serous tumors with microinvasion, non-invasive and invasive peritoneal implants and a micropapillary pattern, and of mucinous tumors with microinvasion, intraepithelial carcinoma and pseudomyxoma peritoneal implants, in addition to further delineation of endometrial, clear cell and transitional cell tumors with atypical proliferation. This review outlines the most recent information regarding the epidemiology, pathology and clinical management of borderline tumors. Surgical management to excise all visible tumors remains the cornerstone of therapy. Because borderline ovarian tumors often occur in reproductive-age women, fertility is an important issue. Conservative surgery is a safe in carefully selected patients. Effective non-surgical therapies are yet to be identified.

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Surgery as sole treatment for serous borderline tumors of the ovary with noninvasive implants

Cited by 29 publications

References 34 publications

Predictive value of CA 125 and CA 72-4 in ovarian borderline tumors

Predictive value of CA 125 and CA 72-4 in ovarian borderline tumors

Peritoneal carcinoma in women with genetic susceptibility: implications for Jewish populations

Borderline ovarian tumors

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