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Risk Factors for Progression to Invasive Carcinoma in Patients With Borderline Ovarian Tumors
  1. Taejong Song, MD*,
  2. Yoo-Young Lee, MD, PhD,
  3. Chel Hun Choi, MD,
  4. Tae-Joong Kim, MD,
  5. Jeong-Won Lee, MD, PhD,
  6. Duk-Soo Bae, MD, PhD and
  7. Byoung-Gie Kim, MD, PhD
  1. *Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and
  2. Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea.
  1. Address correspondence and reprint requests to Byoung-Gie Kim, MD, PhD, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong, Gangnam-gu, Seoul 135-710, Republic of Korea. E-mail: bgkim{at}skku.edu.

Abstract

Objective The aim of this study was to identify risk factors for progression to invasive carcinoma in patients with borderline ovarian tumors (BOTs).

Methods We performed a retrospective review of all patients treated and followed for BOTs between 1996 and 2011. Multivariate Cox proportional hazards model analysis was performed to identify independent risk factors for progression to invasive carcinoma.

Results A total of 364 patients were identified. During the median follow-up of 53.8 months, 31 patients (8.5%) developed recurrent disease: 12 (3.3%) had recurrent disease with progression to invasive carcinoma, and 19 (5.2%) had recurrent disease with borderline histology. Disease-related deaths (7/364; 1.7%) were observed only in patients with progression to invasive carcinoma. The multivariate analysis showed that independent risk factors for progression to invasive carcinoma were advanced disease stage (hazard ratio [HR], 5.59; P = 0.005), age 65 years or older (HR, 5.13; P = 0.037), and the presence of microinvasion (HR, 3.71; P = 0.047). These 3 factors were also independently related to overall survival.

Conclusions Although patients with BOTs have an excellent prognosis, the risk of progression to invasive carcinoma and thereby death remains. Therefore, physicians should pay closer attention to BOT patients with these risk factors (ie, advanced disease stage, old age, and microinvasion), and more careful surveillance for progression to invasive carcinoma is needed.

  • Borderline ovarian tumors
  • Risk factors
  • Recurrence
  • Progression to invasive carcinoma

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Footnotes

  • The authors declare no conflicts of interest.

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