Article Text

Download PDFPDF
Systematic Evaluation of the Intraoperative Tumor Pattern in Patients With Borderline Tumor of the Ovary
  1. Christina Fotopoulou, MD*,
  2. Guido Schumacher, PhD,
  3. Joerg C. Schefold, MD,
  4. Carsten Denkert, PhD§,
  5. Werner Lichtenegger, PhD* and
  6. Jalid Sehouli, PhD*
  1. * Departments of Gynecology and Obstetrics,
  2. General, Visceral and Transplantation Surgery, Charité University Hospital,
  3. Department of Nephrology and Intensive Care, Charité University Medicine, Campus Virchow-Clinic, and
  4. § Institute of Pathology, Charité University Hospital, University Medicine of Berlin, Berlin, Germany.
  1. Address correspondence and reprint requests to Christina Fotopoulou, MD, Department of Gynecology and Obstetrics, Charité University Hospital, Campus Virchow-Clinic, Augustenburger Platz 1, 13353 Berlin, Germany. E-mail: christina.fotopoulou{at}


Objective: Borderline ovarian tumors (BOTs) are rare entities with excellent prognosis depending on tumor stage and presence of invasive implants. There are limited data regarding the intraoperative tumor pattern, the actual base of optimal treatment planning. We conducted a systematic evaluation of the macroscopic and microscopic tumor spreads in patients with BOTs with special focus on the diagnosis of invasive and noninvasive lesions.

Methods: Between January 2001 and July 2008, data of patients with BOTs were evaluated using a systematic and validated documentation tool (intraoperative mapping of ovarian cancer). Surgical outcome and pathological findings were analyzed.

Results: Fifty-one patients underwent surgery for BOT. Mean (SD) age was 47.76 (15.9) years. In 6 patients (11.8%), surgery was performed for recurrence. Complete tumor resection was achieved in 47 patients (92.15%), whereas mean (SD) operative time was 126.34 (73.4) minutes. Pathologic evaluation identified 12 patients (23.53%) with mucinous and 39 patients (76.47%) with serous histologic diagnoses. Twenty-nine (56.86%) and 22 patients (43.13%) were found to have unilateral and bilateral ovarian involvements, respectively. Sixteen patients (31.37%) presented extraovarian involvement into the peritoneum (23.5%), omentum (17.7%), uterus (7.84%), sigmoid (7.8%), lymph nodes (7.8%), ileum (3.9%), mesentery (5.9%), and appendix (1.96%). Twenty patients (39.2%) had implants; of those, 9 (17.64%) and 11 patients (21.6%) have invasive and noninvasive lesions, respectively. Eight of the 9 patients with positive peritoneal cytology were associated with the presence of peritoneal implants; 3 of them with invasive character.

Conclusions: Borderline ovarian tumors require a systematic surgical evaluation to verify or exclude extrapelvic tumor lesions and allow further clinical relevant differentiation between invasive and noninvasive implants.

  • Borderline ovarian tumor
  • Tumor pattern
  • Implants
  • Gynecologic surgery

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.