Borderline Tumors of the Ovary: Clinical Course and Prognostic Factors

Onkologie. 2012;35(1-2):28-33. doi: 10.1159/000336140. Epub 2012 Jan 23.

Abstract

Background: The prognosis in borderline tumors of the ovary (BOT) is generally favorable. However, some patients experience recurrence, and mortalities occur. There is a need to better characterize prognostic factors to be considered for individualized treatment planning.

Patients and methods: The data of 158 consecutive patients who underwent surgery for BOT at a tertiary referral center for gynecologic oncology between 1997 and 2008 were retrospectively analyzed.

Results: Most patients had early stage disease, and advanced stages FIGO II/III only occurred in 23.4%. Serous histology was most frequent (68%), followed by mucinous histology (22%). All patients received surgery as initial treatment with no adjuvant systemic therapy. 37 patients (40.7% of the patients under the age of 50) had fertility-sparing surgery (FSS). Recurrent disease occurred in 18 (11.4%) patients, and 4 (2.5%) patients died. Independent risk factors for recurrence were FIGO stages > I (hazard ratio (HR) 37.1; 95% confidence interval (CI) 4.5-155.5), tumor rupture (HR 12.4; 95% CI 1.5-61.5), incomplete staging (HR 5.9; 95% CI 1.6-21.3), and FSS in patients < 50 years (HR 8.0; 95% CI 2.0-31.6).

Conclusion: Intraoperative tumor rupture, incomplete staging, and FSS - all influenced by the surgeon - may impose a substantial recurrence risk. Therefore, careful counseling and balancing of risk and benefit are mandatory before therapy is applied, especially if FSS is planned.

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Disease-Free Survival
  • Female
  • Germany / epidemiology
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / epidemiology*
  • Ovarian Neoplasms / therapy*
  • Ovariectomy / statistics & numerical data*
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Antineoplastic Agents