Recurrence of borderline ovarian tumors: a survival analysis

Authors

  • Sahana Punneshetty Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India
  • Anitha Thomas Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India
  • Dhanya Susan Thomas Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India
  • Rachel George Chandy Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India
  • Sherin Daniel Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India
  • Sharon Milton Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India
  • Abraham Peedicayil Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India
  • Ajit Sebastian Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India http://orcid.org/0000-0002-0145-6654

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20213850

Keywords:

Adenocarcinoma, Borderline tumor, Recurrence

Abstract

Background: Borderline ovarian tumors are non-invasive tumors that display greater epithelial proliferation and cytological atypia than benign tumors, but less than carcinomas. They may be treated conservatively in young women, however there is a concern for recurrence and progression to frank malignancy. We aimed to study the clinicopathological features of borderline ovarian tumors and their risk of recurrence.

Methods: We reviewed the electronic and paper charts of all borderline ovarian tumors operated between January 1, 2001 and December 31, 2019 at a tertiary level teaching hospital in India. Descriptive statistics such as proportions and means were used. A survival analysis was done for recurrence and death.

Results: A total of 93 borderline ovarian tumor patients were identified. The most common histology in our study was mucinous 60 (63%) followed by serous 28 (29%). Ninety two (99%) of them were stage I at diagnosis. Microinvasion was present in 27 (26%) of the cases. Out of the 30 fertility sparing operations performed (unilateral salpingo-oophorectomy/cytectomy), 4 (13%) had recurrences and progressed to malignancy. The overall malignancy rate was 4%. There was one mortality secondary to septic shock.

Conclusions: Borderline ovarian tumors account for 10-20% of ovarian epithelial tumors and have extremely good prognosis affecting majorly the reproductive aged women. The low recurrence rate and good five year survival rate, at all the stages of the disease enables to incorporate fertility sparing surgeries as part of the staging.

Author Biographies

Sahana Punneshetty, Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India

Senior Registrar

Department of Gynaecologic Oncology

Anitha Thomas, Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India

Associate Professor

Department of Gynaecologic Oncology

Dhanya Susan Thomas, Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India

Assistant Professor

Department of Gynaecologic Oncology

Rachel George Chandy, Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India

Professor

Department of Gynaecologic Oncology

Sherin Daniel, Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India

Assistant Professor

Department of Pathology

Sharon Milton, Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India

Assistant Professor

Department of Pathology

Abraham Peedicayil, Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India

Professor

Department of Gynaecologic Oncology

Ajit Sebastian, Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu, India

Associate Professor

Dept of Gynaecologic Oncology

References

Markowska J. Borderline tumors of the ovary. In: Ayhan A, Reed N, Gultekin M, Dursun P, eds. Text book of Gynaecology. 3rd edn. Turkey: Guines Publishing; 2016:698-702.

Silverberg SG, Bell DA, Kurman RJ, Seidman JD, Prat J, Ronnett BM, et al. Borderline ovarian tumors: key points and workshop summary. Hum Pathol. 2004;35(8):910-7.

Cho JE. Adnexal mass evaluation: evaluation and treatment. In: Ayhan A, Reed N, Gultekin M, Dursun P, eds. Text book of Gynaecology. 3rd edn. Turkey: Guines Publishing; 2016:671-678.

Fotopoulou C, Schumacher G, Schefold JC, Denkert C, Lichtenegger W, Sehouli J. Systematic evaluation of the intraoperative tumor pattern in patients with borderline tumor of the ovary. Int J Gynecol Cancer. 2009;19(9):1550-5.

Singh N. Pathology of malignant and borderline ovarian tumors. In: Ayhan A, Reed N, Gultekin M, Dursun P, eds). Text book of Gynaecology. 3rd edn. Turkey: Guines Publishing; 2016:689-697.

Longacre TA, McKenney JK, Tazelaar HD, Kempson RL, Hendrickson MR. Ovarian serous tumors of low malignant potential (borderline tumors): outcome-based study of 276 patients with long-term (≥5-year) follow-up. Am J Surg Pathol. 2005;29:707-23

Khunamornpong S, Settakorn J, Sukpan K, Suprasert P, Siriaunkgul S. Mucinous tumor of low malignant potential (“borderline” or “atypical proliferative” tumor) of the ovary: a study of 171 cases with the assessment of intraepithelial carcinoma and microinvasion. Int J Gynecol Pathol. 2011;30:218-30.

Kim KR, Lee HI, Lee SK, Ro JY, Robboy SJ. Is stromal microinvasion in primary mucinous ovarian tumors with “mucin granuloma” true invasion? Am J Surg Pathol. 2007;31:546-54.

Roth LM, Emerson RE, Ulbright TM. Ovarian endometrioid tumors of low malignant potential: a clinicopathologic study of 30 cases with comparison to well-differentiated endometrioid adenocarcinoma. Am J Surg Pathol. 2003;27:1253-9.

Cuatrecasas M, Catasus L, Palacios J, Prat J. (2009). Transitional cell tumors of the ovary: a comparative clinicopathologic, immunohistochemical, and molecular genetic analysis of Brenner tumors and transitional cell carcinomas. Am J Surg Pathol. 2009;33:556-67.

Esheba GE, Longacre TA, Atkins KA, Higgins JP. Expression of the urothelial differentiation markers GATA3 and placental S100 (S100P) in female genital tract transitional cell proliferations. Am J Surg Pathol. 2009;33:347-53.

Liao XY, Xue WC, Shen DH, Ngan HY, Siu MK, Cheung AN. p63 expression in ovarian tumours: a marker for Brenner tumours but not transitional cell carcinomas. Histopathology. 2007;51:477-83.

Wu CH, Mao TL, Vang R, Ayhan A, Wang TL, Kurman RJ, et al. Endocervical-type mucinous borderline tumors are related to endometrioid tumors based on mutation and loss of expression of ARID1A. Int J Gynecol Pathol. 2012;31:297-303.

Michelle BF, William-Browns MY, Crieghton EL, Gynecologic oncology handbook. 1st edn. United states of America: Demos Medical Publishing; 2013.

Gershenson DM, Silva EG, Tortolero‐Luna G, Levenback C, Morris M, Tornos C. Serous borderline tumors of the ovary with noninvasive peritoneal implants. Cancer. 1998;83(10):2157-63.

Downloads

Published

2021-09-27

Issue

Section

Original Research Articles