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Assessing the landscape of ovarian serous borderline tumors
  1. Irini Messini1,
  2. Triada Doulgeraki1,
  3. Dimitris Chrysanthakis1,
  4. Petros Yiannou1,
  5. Theofani Gavresea1,
  6. Christos Papadimitriou2,
  7. Theodoros Panoskaltsis3,
  8. Zannis Voulgaris4,
  9. Athanassios Vlachos4 and
  10. Kitty Pavlakis1,5
  1. 1Pathology Department, “IASO” Women’s Hospital, Maroussi, Greece
  2. 2Oncology Unit, 2nd Department of Surgery Aretaieion Hospital, The National and Kapodistrian University of Athens, Athens, Greece
  3. 32nd Academic Department of Obstetrics & Gynecology, Aretaieion Hospital, The National and Kapodistrian University of Athens, Athens, Greece
  4. 4Department of Gynecological Oncology, “IASO” Women’s Hospital, Maroussi, Greece
  5. 51st Pathology Department, The National and Kapodistrian University of Athens, Athens, Greece
  1. Correspondence to Irini Messini, Pathology Department, “IASO” Women’s Hospital, Maroussi 151 23, Greece; messeirini{at}


Aim To compare distinct clinicopathological features between atypical proliferative serous tumors and non-invasive low-grade ovarian serous carcinomas.

Methods Our study group comprised 203 cases of serous borderline tumors sub-classified as atypical proliferative serous tumors or as non-invasive low-grade serous carcinomas. All pathological features related to borderline tumors were re-evaluated by two gynecological pathologists. Data concerning recurrences and survival were retrieved from the medical records of the patients.

Results When comparing atypical proliferative serous tumors to non-invasive low-grade serous carcinomas, the latter were statistically related to advanced stage at diagnosis, bilateral disease, exophytic pattern of growth, microinvasive carcinoma, and the presence of invasive implants. In univariate analysis, recurrences were statistically related to the exophytic pattern of growth, to microinvasion, and to the presence of implants (both invasive and non-invasive). Nevertheless, in multivariate analysis, only microinvasion and the presence of invasive implants were related to recurrence. Women who eventually succumbed to the disease were only those with invasive implants. Their ovarian tumor was either a non-invasive low-grade serous carcinoma or an atypical proliferative serous tumor with ‘minimal’ micropapillary pattern. Neither lymph node involvement nor endosalpingiosis seemed to influence the course of the disease.

Conclusions The results of our study underline the increased possibility of non-invasive low-grade serous carcinomas to be related with features indicative of aggressive behavior as opposed to atypical proliferative serous tumors. Nevertheless, irrespective of tumor histology, the presence of invasive implants and microinvasion were the only independent prognostications of recurrence.

  • serous borderline tumors
  • ovary

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned, externally peer reviewed.