Role of hysterectomy and lymphadenectomy in the management of early-stage borderline ovarian tumors

Borderline Ovarian tumors are tumors of uncertain malignant potential. They have favour able prognosis. They occur in younger women and present at an early stage. They are difficult to diagnose preoperatively as macroscopic picture is a combination of benign and invasive ovarian tumors. Over the years surgical treatment has changed from radical to conservative approach without overlooking oncologic safety. Follows up is essential. Prolonged follow up (>10 yrs) is required because of later recurrences. Special attention is to be paid to the conserved ovary in follow up.

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Borderline Ovarian Tumors: Fifteen Years’ Experience at a Scottish Tertiary Cancer Center

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001364 ◽

2018 ◽

Vol 28 (9) ◽

pp. 1683-1691 ◽

Cited By ~ 6

Author(s):

James May ◽

Karolina Skorupskaite ◽

Mario Congiu ◽

Nidal Ghaoui ◽

Graeme A. Walker ◽

...

Keyword(s):

Malignant Transformation ◽

Surgical Management ◽

Early Stage ◽

Ovarian Tumors ◽

Ca 125 ◽

Ovarian Malignancy ◽

Borderline Ovarian Tumors ◽

Gynecology And Obstetrics ◽

Preoperative Serum

ObjectivesSince the recognition of borderline ovarian tumors (BOTs) in the 1970s, the management of this subset of epithelial ovarian tumors has presented a challenge to clinicians. The majority present at an early stage, but their diagnosis is often only made following surgery, hence the heterogeneity of surgical management. Borderline ovarian tumors are morphologically diverse, and their behavior is subsequently also heterogeneous. We aimed to assess recurrence rates and the rate of malignant transformation in patients diagnosed with BOT. Secondary objectives included a review of current management and assessment of tumor markers, stage, cyst dimensions, and the presence of micropapillary features as prognostic indicators of recurrence.MethodsThis retrospective cohort study included all patients treated with BOT between 2000 and 2015 in the southeast region of Scotland. Clinical, surgicopathological, and follow-up data were collated. Data were analyzed with reference to recurrence and malignant transformation.ResultsTwo hundred seventy-five patients underwent treatment for BOT in the study period. Surgical management was highly variable. A diagnosis of recurrent/persistent BOT or ovarian malignancy following initial treatment of BOT was rare, with only 12 (4%) of 275 cases. There were 7 cases (3%) of ovarian malignancy. Advanced International Federation of Gynecology and Obstetrics stage was the most prominent prognostic factor. Elevated preoperative serum CA-125 and the presence of micropapillary features correlated with advanced stage at presentation. With a lack of clear guidance, follow-up was highly variable with a median of 43 months (0–136 months).ConclusionsTo our knowledge, this study is the largest BOT cohort in the United Kingdom. Recurrent disease is rare in optimally staged, completely resected, early-stage BOT, without high-risk features. Caution is needed in women electing not to undergo completion staging after diagnosis and in those opting for a fertility-preserving approach. Thorough informed consent and clear plans for surveillance and follow-up are needed with consideration of delayed completion surgery as appropriate.

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Role of Retinoblastoma Protein Family (Rb/p105 and Rb2/p130) Expression in the Histopathological Classification of Borderline Ovarian Tumors

Frontiers in Medicine ◽

10.3389/fmed.2020.596226 ◽

2020 ◽

Vol 7 ◽

Author(s):

Valeria Masciullo ◽

Paola Valdivieso ◽

Giulia Amadio ◽

Angela Santoro ◽

Giuseppe Angelico ◽

...

Keyword(s):

Retinoblastoma Protein ◽

Protein Family ◽

Ovarian Tumors ◽

Histopathological Classification ◽

Borderline Ovarian Tumors

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Impact of infertility treatment in patients with previous history of borderline ovarian tumors: Results of a multicenter study

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.5055 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 5055-5055

Author(s):

A. Fortin ◽

P. Morice ◽

A. Thoury ◽

C. Yazbeck ◽

S. Camatte ◽

...

Keyword(s):

Retrospective Study ◽

Early Stage ◽

Case Reports ◽

Previous History ◽

Infertility Treatment ◽

Ovarian Tumors ◽

Borderline Ovarian Tumors ◽

History Of

5055 Background: The use of infertility drugs (ID) in infertile patients treated conservatively for ovarian malignancies remains theoretically contraindicated. Few recent case reports seem to suggest that ID could be used in patients treated for a borderline ovarian tumors (BOT). The aim of this multicenter retrospective study was to report the outcomes of the largest series of patients with a previous history of a BOT who underwent the use of ID. Methods: A multicenter retrospective study was conducted among centers which participate in the French National Register on In Vitro Fertilization registry to evaluate the outcomes of patients with a previous history of a BOT treated with ID. Four criteria were defined to select cases: 1. Histologic confirmation of BOT, 2. The use of a conservative surgery, 3. The use of ID and 4. A follow-up ≥ 12 months after the end of infertility treatment. Results: Thirty cases fulfilled inclusion criteria. Infertility therapy began in November 1989. Disease stages were: I (n = 20), II /III with noninvasive implants (n = 8) and unknown in 2 cases. The mean number of cycles of ovarian induction per patient was 2.6 (range,1–10). After a median follow-up of 42 months after infertility treatment, 4 recurrences were observed (all of them were borderline tumors on a remaining ovary treated by surgery alone). All patients are currently disease-free. Thirteen patients have since become pregnant. The median interval between treatment of the BOT and the use of ID is shorter in patients who relapsed compared to patients who did not (5 versus 29 months; p=.07). Conclusions: These results suggest that infertility drugs could be safely used in patients who experience infertility after conservative management of an early-stage BOT. A minimal interval should be respected between treatment of the ovarian tumor and the use of infertility drugs in order to decrease the risk of recurrence. No significant financial relationships to disclose.

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OP03.07: Borderline ovarian tumors and frozen section: role of preoperative He4 and ROMA score to increase frozen section accuracy

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.15129 ◽

2015 ◽

Vol 46 ◽

pp. 61-61

Author(s):

S. Gizzo ◽

M. Noventa ◽

A. Vitagliano ◽

M. Quaranta ◽

R. Venturella ◽

...

Keyword(s):

Frozen Section ◽

Ovarian Tumors ◽

Borderline Ovarian Tumors

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Utero-ovarian preservation and overall survival of young women with early-stage borderline ovarian tumors

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-019-05121-z ◽

2019 ◽

Vol 299 (6) ◽

pp. 1651-1658 ◽

Cited By ~ 1

Author(s):

Rachel S. Mandelbaum ◽

Erin A. Blake ◽

Hiroko Machida ◽

Brendan H. Grubbs ◽

Lynda D. Roman ◽

...

Keyword(s):

Overall Survival ◽

Young Women ◽

Early Stage ◽

Ovarian Tumors ◽

Ovarian Preservation ◽

Borderline Ovarian Tumors

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Borderline Ovarian Tumors

Handbook of Research on Oncological and Endoscopical Dilemmas in Modern Gynecological Clinical Practice - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-7998-4213-2.ch016 ◽

2021 ◽

pp. 223-239

Author(s):

George Pados ◽

Dimitrios Zouzoulas

Keyword(s):

Ovarian Cancer ◽

Gold Standard ◽

Early Stage ◽

Ovarian Tumors ◽

Microscopic Appearance ◽

Borderline Tumors ◽

Non Invasive ◽

Borderline Ovarian Tumors ◽

Specific Subgroup ◽

Serous Tumors

Borderline ovarian tumors (BOTs) are a specific subgroup of ovarian tumors and are characterized by cell proliferation and nuclear atypia without invasion or stromal invasion. They are usually more present in younger people than the invasive ovarian cancer and are diagnosed at an early stage and thus have a better prognosis. Histologically, borderline tumors are divided into serous (50%), mucosal (46%), and mixed (4%). The serous tumors are bilateral in 30% of the cases and are accompanied by infiltrations outside the ovary in 35% of the cases. These infiltrations may be non-invasive or invasive depending on their microscopic appearance and may affect treatment. Surgery is the approach of choice, and laparoscopic surgery, with the undeniable advantages it offers today, is the “gold standard.” All the surgical steps required to properly treat borderline tumors, at both diagnostic and therapeutic levels, can be safely and successfully be applied laparoscopically. Manipulations during surgery should be limited, and biopsies for rapid biopsy should be done within an endoscopic bag.

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