The management of borderline epithelial tumors of the ovary

Burger, Curt W.; Prinssen, Helma M.; Baak, Jan P. A.; Wagenaar, Nils; Kenemans, P.

doi:10.1046/j.1525-1438.2000.010003181.x

Cited by 53 publications

(45 citation statements)

References 166 publications

(200 reference statements)

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“…Patients with borderline ovarian tumors are, in general, 10 years younger than women with epithelial ovarian cancer (45 vs. 55 years) [14,15]. A third of patients diagnosed with BOTs are younger than 40 years of age and frequently are candidates for fertility-sparing surgery [3,10].…”

Section: Epidemiologymentioning

confidence: 99%

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

et al. 2012

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After completing this course, the reader will be able to:1. Compare the epidemiologic and reproductive risk factors in BOTs with those in ovarian cancers and describe the molecular background of development of BOTs.2. Use the pathological terminology with either original grouping of borderline category or new subclassification of BOTs and assess the major predictor of recurrence and survival.3. Determine an appropriate diagnostic algorithm for patients with symptoms suggesting malignant ovarian tumors that will identify borderline ovarian tumors when present.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBorderline ovarian tumors represent a heterogeneous group of noninvasive tumors of uncertain malignant potential with characteristic histology. They occur in younger women, are present at an early stage, and have a favorable prognosis, but symptomatic recurrence and death may be found as long as 20 years after therapy in some patients. The molecular changes in borderline ovarian tumors indicate linkage of this disease to type I ovarian tumors (lowgrade ovarian carcinomas). The pathological stage of disease and subclassification of extraovarian disease into invasive and noninvasive implants, together with the presence of postoperative macroscopic residual disease, appear to be the major predictor of recurrence and survival. However, it should be emphasized that the most important negative prognostic factor for recurrence is just the use of conservative surgery, but without any impact on patient survival because most recurrent diseases are of the borderline type-easily curable and with an excellent prognosis. Borderline tumors are difficult masses to correctly preoperatively diagnose using imaging methods because their macroscopic features may overlap with invasive and benign ovarian tumors. Over the past several decades, surgical therapy has shifted from a radical approach to more conservative treatment; however, oncologic safety must always be balanced. Follow-up is essential using routine ultrasound imaging, with special attention paid to the remaining ovary in conservatively treated patients. Current literature on this topic leads to a number of controversies that will be discussed thoroughly in this article, with the aim to provide recommendations for the clinical management of these patients. The Oncologist

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Section: Epidemiologymentioning

confidence: 99%

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

et al. 2012

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“…LMPs show epithelial proliferation with stratification and cytologic atypia with no stromal invasion, although microinvasion can be observed (Tavassoli, 1988). In contrast, TOVs exhibit a high mitotic index, cytologic atypia and stromal invasion (Burger et al, 2000;Dietel and Hauptmann, 2000). Several histopathological subtypes are recognized including: serous, mucinous, endometrioid, clear cell and Brenner, as well as mixed and undifferentiated histopathologies.…”

Section: Introductionmentioning

confidence: 99%

Discrimination between serous low malignant potential and invasive epithelial ovarian tumors using molecular profiling

et al. 2005

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Tumors of low malignant potential (LMP) represent 20% of epithelial ovarian cancers (EOCs) and are associated with a better prognosis than the invasive tumors (TOV). Defining the relationship between LMPs and TOVs remains an important goal towards understanding the molecular pathways that contribute to prognosis, as well as providing molecular markers, for these EOCs. To this end, DNA microarray analyses were performed either in a primary culture or a tumor tissue model system and selected candidate genes showing a distinctive expression profile between LMPs and TOVs were identified using a class prediction approach based on three statistical methods of analysis. Both model systems appear relevant as candidate genes identified by either model allowed the proper reclassification of samples as either LMPs or TOVs. Selected candidate genes (CAS, CCNE1, LGALS8, ITGb3, ATP1B1, FLIP, KRT7 and KRT19) were validated by real-time quantitative PCR analysis and show differential expression between LMPs and TOVs. Immunohistochemistry analyses showed that the two tumor classes were distinguishable by their expression of CAS, TNFR1A, FLIP, CKS1 and CCNE1. These results define signature patterns for gene expression of LMPs and TOVs and identify gene candidates that warrant further study to deepen our understanding of the biology of EOC.

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“…However, LMPs are morphologically distinct from TOVs, as they present no invasion of the ovarian stroma although microinvasion can be observed. [3][4][5] EOCs are graded according to degree of differentiation: LMPs (referred to as either grade B or grade 0) are minimal deviation from their benign counterpart while well-differentiated tumors are grade 1 (G1), moderately differentiated are grade 2 (G2) and poorly differentiated are grade 3 (G3) carcinomas. Four stages are used according to the volume and extent of tumor spread.…”

mentioning

confidence: 99%

Tissue array analysis of expression microarray candidates identifies markers associated with tumor grade and outcome in serous epithelial ovarian cancer

Ouellet

Guyot

Page

et al. 2006

Intl Journal of Cancer

118

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Molecular profiling is a powerful approach to identify potential clinical markers for diagnosis and prognosis as well as providing a better understanding of the biology of epithelial ovarian cancer. On the basis of the analysis of HuFL expression data, we have previously identified genes that distinguish low malignant potential and invasive serous epithelial ovarian tumors. In this study, we used immunohistochemistry to monitor a subset of differently expressed candidates (Ahr, Paep, Madh3, Ran, Met, Mek1, Ccne1, Ccd20, Cks1 and Cas). A tissue array composed of 244 serous tumors of different grades (0–3) and stages (I–IV) was used in this analysis. All markers assayed presented differential protein expression between serous tumors of low and high grade. Significant differences in Ccne1 and Ran expression were observed in a comparison of low malignant potential and grade 1 tumor samples (p < 0.01). In addition, irrespective of the grade, Ccne1, Ran, Cdc20 and Cks1 showed significant differences of expression in association with the clinical stage of disease. While high level of Ccne1 have previously been associated with poor outcomes, here we found that high level of either Ran or Cdc20 appear to be more tightly associated with a poor prognosis (p < 0.001, 0.03, respectively). The application of these biomarkers in both the initial diagnosis and prognostic attributes of patients with epithelial ovarian tumors should prove to be useful in patient management. © 2006 Wiley‐Liss, Inc.

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The management of borderline epithelial tumors of the ovary

Cited by 53 publications

References 166 publications

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

Discrimination between serous low malignant potential and invasive epithelial ovarian tumors using molecular profiling

Tissue array analysis of expression microarray candidates identifies markers associated with tumor grade and outcome in serous epithelial ovarian cancer

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