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Open Access 01-11-2021 | Laparoscopy | Gynecologic Oncology

Status of Surgical Management of Borderline Ovarian Tumors in France: are Recommendations Being Followed? Multicentric French Study by the FRANCOGYN Group

Authors: Lise Lecointre, MD, Virginie Bund, MD, Eva Sangnier, MD, Lobna Ouldamer, MD, Sofiane Bendifallah, MD, Martin Koskas, PhD, Pierre-Adrien Bolze, MD, Pierre Collinet, MD, Geoffroy Canlorbe, MD, Cyril Touboul, PhD, Cyrille Huchon, PhD, Charles Coutant, PhD, Emilie Faller, MD, Thomas Boisramé, MD, Justine Gantzer, MD, Martin Demarchi, MD, Vincent Lavoué, PhD, Chérif Akladios, PhD

Published in: Annals of Surgical Oncology | Issue 12/2021

Abstract

Background

Borderline ovarian tumors (BOTs) are tumors with a favorable prognosis but whose management by consensus is essential to limit the risk of invasive recurrence. This study aimed to conduct an inventory of surgical practices for BOT in France and to evaluate the conformity of the treatment according to the current French guidelines.

Methods

This retrospective, multicenter cohort study included nine referral centers of France between January 2001 and December 2018. It analyzed all patients with serous and mucinous BOT who had undergone surgery. A peritoneal staging in accordance with the recommendations was defined by performance of a peritoneal cytology, an omentectomy, and at least one peritoneal biopsy.

Results

The study included 332 patients. A laparoscopy was performed in 79.5% of the cases. Treatment was conservative in 31.9% of the cases. The recurrence rate was significantly increased after conservative treatment (17.3% vs 3.1%; p < 0.001). Peritoneal cytology was performed for 95.5%, omentectomy for 83.1%, and at least one biopsy for 82.2% of the patients. The overall recurrence rate was 7.8%, and the recurrence was invasive in 1.2% of the cases. No link was found between the recurrence rate and the conformity of peritoneal staging. The overall rate of staging noncompliance was 22.9%.

Conclusion

The current standards for BOT management seem to be well applied.

Taylors HC. Malignant and semimalignant tumors of the ovary. Surg Gynecol Obstet. 1929;48:204–30.

Hart WR. Borderline epithelial tumors of the ovary. Mod Pathol. 2005;18:33–50. https://doi.org/10.1038/modpathol.3800307.CrossRef

Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist. 2012;17:1515–33. https://doi.org/10.1634/theoncologist.2012-0139.CrossRefPubMedPubMedCentral

Tropé CG, Kaern J, Davidson B. Borderline ovarian tumours. Best Pract Res Clin Obstet Gynaecol. 2012;26:325–36. https://doi.org/10.1016/j.bpobgyn.2011.12.006.CrossRefPubMed

Sobin LH. The international histological classification of tumours. Bull World Health Organ. 1981;59:813–9.PubMedPubMedCentral

Acs G. Serous and mucinous borderline (low malignant potential) tumors of the ovary. Am J Clin Pathol. 2005. https://doi.org/10.1309/J6PXXK1HQJAEBVPM.CrossRefPubMed

Vasconcelos I, Darb-Esfahani S, Sehouli J. Serous and mucinous borderline ovarian tumours: differences in clinical presentation, high-risk histopathological features, and lethal recurrence rates. BJOG Int J Obst Gynaecol. 2016;123:498–508. https://doi.org/10.1111/1471-0528.13840.CrossRef

Uzan C, Kane A, Rey A, Gouy S, Duvillard P, Morice P. Outcomes after conservative treatment of advanced-stage serous borderline tumors of the ovary. Ann Oncol. 2009;21:55–60. https://doi.org/10.1093/annonc/mdp267.CrossRefPubMed

Bendifallah S, Ballester M, Uzan C, Fauvet R, Morice P, Darai E. Nomogram to predict recurrence in patients with early- and advanced-stage mucinous and serous borderline ovarian tumors. Am J Obstet Gynecol. 2014;211:637.e1-637.e6. https://doi.org/10.1016/j.ajog.2014.06.028.CrossRef

10.

Fauvet R, Poncelet C, Boccara J, Descamps P, Fondrinier E, Daraï E. Fertility after conservative treatment for borderline ovarian tumors: a French multicenter study. Fertil Steril. 2005;83:284–90. https://doi.org/10.1016/j.fertnstert.2004.10.009.

11.

Uzan C, Muller E, Kane A, et al. Prognostic factors for recurrence after conservative treatment in a series of 119 patients with stage I serous borderline tumors of the ovary. Ann Oncol. 2014;25:166–71. https://doi.org/10.1093/annonc/mdt430.CrossRefPubMed

12.

Canlorbe G, Lecointre L, Chauvet P, Azaïs H, Fauvet R, Uzan C. Borderline ovarian tumours: CNGOF guidelines for clinical practice–therapeutic management of early stages. Gynecol Obstet Fertilite Senologie. 2020;48:287–303. https://doi.org/10.1016/j.gofs.2020.01.016.CrossRef

13.

Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83. https://doi.org/10.1016/0021-9681(87)90171-8.CrossRefPubMed

14.

Morice P, Uzan C, Fauvet R, Gouy S, Duvillard P, Darai E. Borderline ovarian tumour: pathological diagnostic dilemma and risk factors for invasive or lethal recurrence. Lancet Oncol. 2012. https://doi.org/10.1016/S1470-2045(11)70288-1.CrossRefPubMed

15.

Observatoire des Tumeurs Malignes Rares Gynécologique. Site des centres experts des TMRGs. Published 2018. Retrieved 16 September 2020 at http://www.ovaire-rare.org/TMRG/medecin/tumeur_borderline.aspx.

16.

Poncelet C, Fauvet R, Boccara J, Daraï E. Recurrence after cystectomy for borderline ovarian tumors: results of a French multicenter study. Ann Surg Oncol. 2006;13:565–71. https://doi.org/10.1245/ASO.2006.12.024.CrossRefPubMed

17.

Fauvet R, Boccara J, Dufournet C, Poncelet C, Daraï E. Laparoscopic management of borderline ovarian tumors: results of a French multicenter study. Ann Oncol. 2005;16:403–10. https://doi.org/10.1093/annonc/mdi083.CrossRefPubMed

18.

Delle Marchette M, Ceppi L, Andreano A, Bonazzi CM, Buda A, Grassi T, et al. Oncologic and fertility impact of surgical approach for borderline ovarian tumours treated with fertility sparing surgery. Eur J Cancer Oxf Engl. 1990;111:61–8.CrossRef

19.

Song T, Kim MK, Jung YW, et al. Minimally invasive compared with open surgery in patients with borderline ovarian tumors. Gynecol Oncol. 2017;145:508–12. https://doi.org/10.1016/j.ygyno.2017.03.019.CrossRefPubMed

20.

Lenhard MS, Mitterer S, Kümper C, et al. Long-term follow-up after ovarian borderline tumor: relapse and survival in a large patient cohort. Eur J Obstet Gynecol Reprod Biol. 2009;145:189–94. https://doi.org/10.1016/j.ejogrb.2009.04.031.CrossRefPubMed

21.

McCluggage WG. Ovarian borderline tumours: a review with comparison of serous and mucinous types. Diagn Histopathol. 2014;20:333–50.CrossRef

22.

Song T, Kim MK, Jung YW, et al. The role of appendectomy in patients with mucinous borderline ovarian tumors. Eur J Obstet Gynecol Reprod Biol. 2018;229:112–6. https://doi.org/10.1016/j.ejogrb.2018.06.034.CrossRefPubMed

23.

Matsuo K, Machida H, Takiuchi T, et al. Role of hysterectomy and lymphadenectomy in the management of early-stage borderline ovarian tumors. Gynecol Oncol. 2017;144:496–502. https://doi.org/10.1016/j.ygyno.2017.01.019.CrossRefPubMedPubMedCentral

24.

Helpman L, Yaniv A, Beiner ME, et al. Fertility preservation in women with borderline ovarian tumors: how does it impact disease outcome? A cohort study. Acta Obstet Gynecol Scand. 2017;96:1300–6. https://doi.org/10.1111/aogs.13203.CrossRefPubMed

25.

Ouldamer L, Bendifallah S, Nikpayam M, et al. Improving the clinical management of women with borderline tumours: a recurrence risk scoring system from a French multicentre study. BJOG Int J Obstet Gynaecol. 2017;124:937–44. https://doi.org/10.1111/1471-0528.14577.CrossRef

26.

Shim SH, Kim SN, Jung PS, Dong M, Kim JE, Lee SJ. Impact of surgical staging on prognosis in patients with borderline ovarian tumours: a meta-analysis. Eur J Cancer. 2016;54:84–95. https://doi.org/10.1016/j.ejca.2015.11.005.CrossRefPubMed

27.

Seong SJ, Kim DH, Kim MK, Song T. Controversies in borderline ovarian tumors. J Gynecol Oncol. 2015;26:343–9. https://doi.org/10.3802/jgo.2015.26.4.343.CrossRefPubMedPubMedCentral

28.

Querleu D, Papageorgiou Th, Lambaudie E, Sonoda Y, Narducci F, LeBlanc E. Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours. BJOG Int J Obstet Gynaecol. 2003;110:201–4. https://doi.org/10.1046/j.1471-0528.2003.02276.x.CrossRef

Title: Status of Surgical Management of Borderline Ovarian Tumors in France: are Recommendations Being Followed? Multicentric French Study by the FRANCOGYN Group
Authors: Lise Lecointre, MD
Virginie Bund, MD
Eva Sangnier, MD
Lobna Ouldamer, MD
Sofiane Bendifallah, MD
Martin Koskas, PhD
Pierre-Adrien Bolze, MD
Pierre Collinet, MD
Geoffroy Canlorbe, MD
Cyril Touboul, PhD
Cyrille Huchon, PhD
Charles Coutant, PhD
Emilie Faller, MD
Thomas Boisramé, MD
Justine Gantzer, MD
Martin Demarchi, MD
Vincent Lavoué, PhD
Chérif Akladios, PhD
Publication date: 01-11-2021
Publisher: Springer International Publishing
Keyword: Laparoscopy
Published in: Annals of Surgical Oncology / Issue 12/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-021-09852-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Status of Surgical Management of Borderline Ovarian Tumors in France: are Recommendations Being Followed? Multicentric French Study by the FRANCOGYN Group

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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