Article Text

Download PDFPDF
Outcome of Patients With Advanced-Stage Borderline Ovarian Tumors After a First Peritoneal Noninvasive Recurrence: Impact on Further Management
  1. Catherine Uzan, MD, PhD*,
  2. Anne-sophie Zanini-Grandon, MD*,
  3. Enrica Bentivegna, MD*,
  4. Sebastien Gouy, MD, PhD*,
  5. Alexandra Leary, MD, PhD,
  6. Pierre Duvillard, MD and
  7. Philippe Morice, MD, PhD*,§
  1. *Departments of Gynecologic Surgery,
  2. Departments of Oncology, and
  3. Departments of Pathology,
  4. §Departments of University Paris Sud, Gustave Roussy Cancer Campus, Villejuif, France.
  1. Address correspondence and reprint requests to Catherine Uzan, MD, PhD, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, 94805 Villejuif, France. E-mail: catherine.uzan@gustaveroussy.fr.

Abstract

Objectives The aims of this study were to report the outcome of patients with advanced-stage serous borderline ovarian tumors (SBOT) after a first noninvasive recurrence and the impact of conservative treatment in that context and to define the best management for those patients.

Study Design From 1973 to 2006, 168 patients were treated at or referred to our institution for an SBOT with peritoneal implants. Their slides were reviewed by the same expert pathologist. Selection criteria were as follows: advanced stage (International Federation of Gynecology and Obstetrics ≥II), with at least 1 recurrence (only noninvasive ones) and more than 5 years of follow-up.

Results Twenty patients met the inclusion criteria. The median duration of follow-up was 12 years (range, 6–23 years). Median age was 26 years (14–61 years). Initial surgical management was conservative for 14 patients and radical for 6. In the study population, 4 patients recurred, all with invasive disease. Time to invasive recurrence was at least 3 years for 3 of 4 patients. None of those 4 patients had a second-look surgery initially or after the first recurrence. Two patients had small-sized residual disease after initial management; only 1 of these 4 patients is currently alive and disease-free. There was no significant difference between conservative and radical treatment of the risk of second recurrence.

Conclusions This study emphasizes the need for a long follow-up after recurrence of advanced-stage SBOT and the risk of a new invasive recurrence after a first noninvasive peritoneal recurrence. Conservative treatment does not seem as a risk factor and is still justified after a first noninvasive recurrence for young patients who desire to preserve fertility.

  • Borderline ovarian tumor
  • Recurrence
  • Noninvasive
  • Invasive
  • Conservative treatment

Statistics from Altmetric.com

Footnotes

  • The authors declare no conflicts of interest.

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.