Borderline ovarian tumors: retrospective study and literature review

Authors

  • Aliya B. Aziz Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan
  • Nosheen Sikandar Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan
  • Humaira Aziz Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan
  • Uzma Chishti Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20231678

Keywords:

Borderline ovarian tumour, Survival, Recurrence, Fertility sparing surgery

Abstract

Background: Borderline Ovarian tumor are epithelial tumors, diagnosed in early stage with excellent prognosis. The risk of recurrence is matter of concern.

Methods: A retrospective, cross-sectional study conducted at OBGYN department of Aga khan hospital Karachi from 2002 to 2018. 

Results: Seventy-three patients with BOT were enrolled with mean age of 40 years. Fertility sparing surgery (FSS) was performed in 35 (48%) while 38 (52%) underwent debulking surgery. Average pre-operative CA-125 IU level was 47 in FSS and 40 in debulking group. Laparotomy was the commonest surgery in both groups with 5 (14%) patients in FSS group having laparoscopy. In debulking group, 3 patients (8%) had residual disease. Majority of patients in both groups had stage 1 disease i.e., 34 (97%) and 34 (89%) respectively. Serous was the most common histological type in both groups while unilateral lesions were prevalent in the FSS group (83% vs. 68%). Recurrence was reported in 3(8.6%) patients in FSS, while 1 (2.6%) in debulking group. Mean time to recurrence was 57.13 months. Amongst the 4 recurrences, 3 patients had FSS and had unilateral tumor, ruptured capsule or surface disease. They had mucinous histology with negative cytology. One from debulking group had recurrence with bilateral tumor, serous histology and stage IIIC. Three patients (9%) conceived in FSS and had live births. The 5-year overall survival was 97.9%. 

Conclusions: BOT have a favorable prognosis. Recurrences occur late in the trajectory of disease and hence regular follow-ups are important. They are common in mucinous tumors with external capsular involvement.

Metrics

Metrics Loading ...

References

Turnbull H, Duncan T. Ovarian, Fallopian Tube and Primary Peritoneal Cancer. Gynaecol Oncol MRCOG. 2018:98:23-9.

Camille C G M, Brian M. Adnexal masses. In: Disaia CW, Mannel R, Mcmeekin DS, Mutch DG eds. Clinical gynaecologic oncology. 9th ed. Phildelphia: Elsevier; 2018:231-52.

Loizzi V, Selvaggi L, Leone L, Latorre D, Scardigno D, Magazzino F, et al. Borderline epithelial tumors of the ovary: Experience of 55 patients. Oncol Letters. 2015;9(2):912-4.

Yasmeen S, Hannan A, Sheikh F, Syed AA, Siddiqui N. Borderline tumors of the ovary: A clinicopathological study. Pak J Med Sci. 2017;33(2): 369.

Morice P, Uzan C, Fauvet R, Gouy S, Duvillard P, Darai E. Borderline ovarian tumour: pathological diagnostic dilemma and risk factors for invasive or lethal recurrence. Lancet Oncol. 2012;13(3):e103-15.

Alvarez RM, Vazquez-Vicente D. Fertility sparing treatment in borderline ovarian tumours. Cancer Med Sci. 2015;9.

Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist. 2012;17(12):1515.

Chen X, Fang C, Zhu T, Zhang P, Yu A, Wang S. Identification of factors that impact recurrence in patients with borderline ovarian tumors. J Ovarian Res. 2017;10(1):23.

Sun Y, Xu J, Jia X. The Diagnosis, Treatment, Prognosis and Molecular Pathology of Borderline Ovarian Tumors: Current Status and Perspectives. Cancer Manag Res. 2020;12:3651-9.

Cadron I, Leunen K, Van Gorp T, Amant F, Neven P, Vergote I. Management of borderline ovarian neoplasms. J Clin Oncol. 2007;25(20):2928-37.

Chen RF, Li J, Zhu TT, Yu HL, Lu X. Fertility-sparing surgery for young patients with borderline ovarian tumors (BOTs): single institution experience. J Ovarian Res. 2016;9:16.

du Bois A, Ewald-Riegler N, de Gregorio N, Reuss A, Mahner S, Fotopoulou C, et al. Borderline tumours of the ovary: a cohort study of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Study Group. Eur J Cancer. 2013;49(8):1905-14.

Trillsch F, Mahner S, Ruetzel J, Harter P, Ewald-Riegler N, Jaenicke F, et al. Clinical management of borderline ovarian tumors. Expert Rev Anticancer Ther. 2010;10(7):1115-24.

Acs G. Serous and mucinous borderline (low malignant potential) tumors of the ovary. Pathol Patterns Rev. 2005;123(1):S13-57.

Morice P, Uzan C, Fauvet R, Gouy S, Duvillard P, Darai E. Borderline ovarian tumour: pathological diagnostic dilemma and risk factors for invasive or lethal recurrence. Lancet Oncol. 2012;13(3):e103-15.

Deffieux X, Morice P, Camatte S, Fourchotte V, Duvillard P, Castaigne D. Results after laparoscopic management of serous borderline tumor of the ovary with peritoneal implants. Gynecol Oncol. 2005;97(1): 84-9.

Fauvet R, Boccara J, Dufournet C, Poncelet C, Darai E. Laparoscopic management of borderline ovarian tumors: results of a French multicenter study. Annals Oncol. 2005;16(3):403-10.

Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist. 2012;17(12):1515-33.

Tropé C, Davidson B, Paulsen T, Abeler V, Kaern J. Diagnosis and treatment of borderline ovarian neoplasms" the state of the art". Eur J Gynaecol Oncol. 2009;30(5):471-82.

Fang C, Zhao L, Chen X, Yu A, Xia L, Zhang P. The impact of clinicopathologic and surgical factors on relapse and pregnancy in young patients (≤40 years old) with borderline ovarian tumors. BMC Cancer. 2018;18(1):1147.

Downloads

Published

2023-05-31

How to Cite

Aziz, A. B., Sikandar, N., Aziz, H., & Chishti, U. (2023). Borderline ovarian tumors: retrospective study and literature review. International Journal Of Community Medicine And Public Health, 10(6), 2031–2036. https://doi.org/10.18203/2394-6040.ijcmph20231678

Issue

Section

Original Research Articles