Skip to main content
Top
Published in: Annals of Surgical Oncology 1/2011

01-01-2011 | Gynecologic Oncology

Prognostic Factors of a Large Retrospective Series of Mucinous Borderline Tumors of the Ovary (Excluding Peritoneal Pseudomyxoma)

Authors: Martin Koskas, MD, Catherine Uzan, MD, PhD, Sebastien Gouy, MD, Patricia Pautier, MD, Catherine Lhommé, MD, Christine Haie-Meder, MD, Pierre Duvillard, MD, Philippe Morice, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2011

Login to get access

Abstract

Background

To determine the prognosis and prognostic factors in a large series of mucinous borderline tumors of the ovary (MBOT).

Materials and Methods

A retrospective review of patients with MBOT treated or referred to our institution. Three inclusion criteria were defined: (1) centralized histological review by our expert pathologist, (2) exclusion of peritoneal pseudomyxoma and any synchronous malignant tumor in the abdominal cavity, and (3) available data on the management and outcomes of patients.

Results

From 1997 to 2004, 97 patients fulfilled inclusion criteria (95 stage I and 2 stage II disease). Of these, 9 patients had endocervical-like subtypes, 8 patients had stromal microinvasion, and 24 had intraepithelial carcinoma. Radical and conservative surgeries were performed, respectively, in 28 and 69 patients. After a median follow-up of 48 months, 13 patients had developed 14 recurrences: 7 were borderline and 7 were invasive lesions. The probability of recurrence in the form of carcinoma 5 and 10 years after the diagnosis was, respectively, 9 and 13%. The only prognostic factor for recurrence attaining statistical significance was the use of a cystectomy (compared with other surgeries relative risk [RR] = 5.6; P = 0.003; compared with salpingo-oophorectomy RR = 5.5; P = 0.012).

Conclusions

In the present series of 97 MBOT, mainly early-stage disease and excluding peritoneal pseudomyxoma, the cumulative risk of recurrence in the form of invasive carcinoma at 10 years was 13%. MBOT do not appear to be such a “safe” disease. The only prognostic factor for recurrence was the use of a cystectomy, suggesting that a salpingo-oophorectomy should be preferred in cases of conservative treatment.
Literature
1.
go back to reference Hart WR. Mucinous tumors of the ovary: a review. Int J Gynecol Pathol. 2005;24:4–25.PubMed Hart WR. Mucinous tumors of the ovary: a review. Int J Gynecol Pathol. 2005;24:4–25.PubMed
2.
go back to reference Ronnett BM, Kajdacsy-Balla A, Gilks CB, Merion MJ, Silva E, Werness BA, et al. Mucinous borderline ovarian tumors: points of general agreement and persistent controversies regarding nomenclature, diagnostic criteria, and behavior. Hum Pathol. 2004;35:949–60.CrossRefPubMed Ronnett BM, Kajdacsy-Balla A, Gilks CB, Merion MJ, Silva E, Werness BA, et al. Mucinous borderline ovarian tumors: points of general agreement and persistent controversies regarding nomenclature, diagnostic criteria, and behavior. Hum Pathol. 2004;35:949–60.CrossRefPubMed
3.
go back to reference Tavassoli FA, Devilee P, editors.World Health Organization: Tumours of the Breast and Female Genital Organs (WHO/IARC Classification of Tumours). IARC Press: Lyon; 2003. Tavassoli FA, Devilee P, editors.World Health Organization: Tumours of the Breast and Female Genital Organs (WHO/IARC Classification of Tumours). IARC Press: Lyon; 2003.
4.
go back to reference International Federation of Gynecology and Obstetrics. Changes in definitions of clinical staging for carcinoma of the cervix and ovary. Am J Obstet Gynecol. 1987;156:263–4. International Federation of Gynecology and Obstetrics. Changes in definitions of clinical staging for carcinoma of the cervix and ovary. Am J Obstet Gynecol. 1987;156:263–4.
5.
go back to reference Sumithran E, Susil BJ, Looi LM. The prognostic significance of grading in borderline mucinous tumors of the ovary. Hum Pathol. 1988;19:15–8.CrossRefPubMed Sumithran E, Susil BJ, Looi LM. The prognostic significance of grading in borderline mucinous tumors of the ovary. Hum Pathol. 1988;19:15–8.CrossRefPubMed
6.
go back to reference Ji H, Yliskoski M, Anttila M, Syrjanen K, Saarikoski S. Management of stage-I borderline ovarian tumors. Int J Gynecol Obstet. 1996;54:37–44.CrossRef Ji H, Yliskoski M, Anttila M, Syrjanen K, Saarikoski S. Management of stage-I borderline ovarian tumors. Int J Gynecol Obstet. 1996;54:37–44.CrossRef
7.
go back to reference Gotlieb W, Flikker S, Davidson B, Korach Y, Kopolovic J, Ben-Baruch G. Borderline tumors of the ovary: fertility treatment, conservative management, and pregnancy outcome. Cancer. 1998;82:141–6.CrossRefPubMed Gotlieb W, Flikker S, Davidson B, Korach Y, Kopolovic J, Ben-Baruch G. Borderline tumors of the ovary: fertility treatment, conservative management, and pregnancy outcome. Cancer. 1998;82:141–6.CrossRefPubMed
8.
go back to reference Zanetta G, Rota S, Chiari S, Bonazzi C, Bratina G, Mangioni C. Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol. 2001;19:2656–64. Zanetta G, Rota S, Chiari S, Bonazzi C, Bratina G, Mangioni C. Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol. 2001;19:2656–64.
9.
go back to reference Suh-Burgmann E. Long-term outcomes following conservative surgery for borderline tumor of the ovary: a large population-based study. Gynecol Oncol. 2006;103:841–7.CrossRefPubMed Suh-Burgmann E. Long-term outcomes following conservative surgery for borderline tumor of the ovary: a large population-based study. Gynecol Oncol. 2006;103:841–7.CrossRefPubMed
10.
go back to reference Yokoyama Y, Moriya T, Takano T, Shoji T, Takahashi O, Nakahara K, et al. Clinical outcome and risks factors for recurrence in borderline ovarian tumours. Br J Cancer. 2006;94:1586–91.PubMed Yokoyama Y, Moriya T, Takano T, Shoji T, Takahashi O, Nakahara K, et al. Clinical outcome and risks factors for recurrence in borderline ovarian tumours. Br J Cancer. 2006;94:1586–91.PubMed
11.
go back to reference Cho YH, Kim DY, Kim JH, Kim YM, Kim KR, Kim YT, et al. Is complete surgical staging necessary in patients with stage I mucinous epithelial ovarian tumors? Gynecol Oncol. 2006;103:878–82.CrossRefPubMed Cho YH, Kim DY, Kim JH, Kim YM, Kim KR, Kim YT, et al. Is complete surgical staging necessary in patients with stage I mucinous epithelial ovarian tumors? Gynecol Oncol. 2006;103:878–82.CrossRefPubMed
12.
go back to reference Wong HF, Low JJ, Chua Y, Busmanis I, Tay EH, Ho TH. Ovarian tumors of borderline malignancy: a review of 247 patients from 1991 to 2004. Int J Gynecol Cancer. 2007;17:342–9.CrossRefPubMed Wong HF, Low JJ, Chua Y, Busmanis I, Tay EH, Ho TH. Ovarian tumors of borderline malignancy: a review of 247 patients from 1991 to 2004. Int J Gynecol Cancer. 2007;17:342–9.CrossRefPubMed
13.
go back to reference Park JY, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH. Surgical management of borderline ovarian tumors: the role of fertility-sparing surgery. Gynecol Oncol. 2009;113:75–82.CrossRefPubMed Park JY, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH. Surgical management of borderline ovarian tumors: the role of fertility-sparing surgery. Gynecol Oncol. 2009;113:75–82.CrossRefPubMed
14.
go back to reference Hart WR, Norris HJ. Borderline and malignant mucinous tumors of the ovary. Cancer. 1973;31:1031–44.CrossRefPubMed Hart WR, Norris HJ. Borderline and malignant mucinous tumors of the ovary. Cancer. 1973;31:1031–44.CrossRefPubMed
15.
go back to reference Siriaunkgul S, Robbins KM, McGowan L, Silverberg SG. Ovarian mucinous tumors of low malignant potential: a clinicopathologic study of 54 tumors of intestinal and müllerian type. Int J Gynecol Pathol. 1995;14:198–208.CrossRefPubMed Siriaunkgul S, Robbins KM, McGowan L, Silverberg SG. Ovarian mucinous tumors of low malignant potential: a clinicopathologic study of 54 tumors of intestinal and müllerian type. Int J Gynecol Pathol. 1995;14:198–208.CrossRefPubMed
16.
go back to reference Bradley RF, Stewart JH 4th, Russell GB, Levine EA, Geisinger KR. Pseudomyxoma peritonei of appendiceal origin: a clinicopathologic analysis of 101 patients uniformly treated at a single institution, with literature review. Am J Surg Pathol. 2006;30:551–9.CrossRefPubMed Bradley RF, Stewart JH 4th, Russell GB, Levine EA, Geisinger KR. Pseudomyxoma peritonei of appendiceal origin: a clinicopathologic analysis of 101 patients uniformly treated at a single institution, with literature review. Am J Surg Pathol. 2006;30:551–9.CrossRefPubMed
17.
go back to reference Ronnett BM, Shmookler BM, Sugarbaker PH, Kurman RJ. Pseudomyxoma peritonei: new concepts in diagnosis, origin, nomenclature, and relationship to mucinous borderline (low malignant potential) tumors of the ovary. Anat Pathol. 1997;2:197–226.PubMed Ronnett BM, Shmookler BM, Sugarbaker PH, Kurman RJ. Pseudomyxoma peritonei: new concepts in diagnosis, origin, nomenclature, and relationship to mucinous borderline (low malignant potential) tumors of the ovary. Anat Pathol. 1997;2:197–226.PubMed
18.
go back to reference Shappell HW, Riopel MA, Smith Sehdev AE, Ronnett BM, Kurman RJ. Diagnostic criteria and behavior of ovarian seromucinous (endocervical-type mucinous and mixed cell-type) tumors: atypical proliferative (borderline) tumors, intraepithelial, microinvasive, and invasive carcinomas. Am J Surg Pathol. 2002;26:1529–41.CrossRefPubMed Shappell HW, Riopel MA, Smith Sehdev AE, Ronnett BM, Kurman RJ. Diagnostic criteria and behavior of ovarian seromucinous (endocervical-type mucinous and mixed cell-type) tumors: atypical proliferative (borderline) tumors, intraepithelial, microinvasive, and invasive carcinomas. Am J Surg Pathol. 2002;26:1529–41.CrossRefPubMed
19.
go back to reference Rodriguez IM, Irving JA, Prat J. Endocervical-like mucinous borderline tumors of the ovary: a clinicopathologic analysis of 31 cases. Am J Surg Pathol. 2004;28:1311–8.CrossRefPubMed Rodriguez IM, Irving JA, Prat J. Endocervical-like mucinous borderline tumors of the ovary: a clinicopathologic analysis of 31 cases. Am J Surg Pathol. 2004;28:1311–8.CrossRefPubMed
20.
go back to reference Rutgers JL, Scully RE. Ovarian mullerian mucinous papillary cystadenomas of borderline malignancy. A clinicopathologic analysis. Cancer. 1988;61:340–8.CrossRefPubMed Rutgers JL, Scully RE. Ovarian mullerian mucinous papillary cystadenomas of borderline malignancy. A clinicopathologic analysis. Cancer. 1988;61:340–8.CrossRefPubMed
21.
go back to reference Riopel MA, Ronnett BM, Kurman RJ. Evaluation of diagnostic criteria and behavior of ovarian intestinal-type mucinous tumors: atypical proliferative (borderline) tumors and intraepithelial, microinvasive, invasive, and metastatic carcinomas. Am J Surg Pathol. 1999;23:617–35.CrossRefPubMed Riopel MA, Ronnett BM, Kurman RJ. Evaluation of diagnostic criteria and behavior of ovarian intestinal-type mucinous tumors: atypical proliferative (borderline) tumors and intraepithelial, microinvasive, invasive, and metastatic carcinomas. Am J Surg Pathol. 1999;23:617–35.CrossRefPubMed
22.
go back to reference Nomura K, Aizawa S. Noninvasive, microinvasive and invasive mucinous carcinomas of the ovary: a clinicopathologic analysis of 40 cases. Cancer. 2000;89:1541–6.CrossRefPubMed Nomura K, Aizawa S. Noninvasive, microinvasive and invasive mucinous carcinomas of the ovary: a clinicopathologic analysis of 40 cases. Cancer. 2000;89:1541–6.CrossRefPubMed
23.
go back to reference Lee KR, Scully RE. Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with “pseudomyxoma peritonei”. Am J Surg Pathol. 2000;24:1447–64.CrossRefPubMed Lee KR, Scully RE. Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with “pseudomyxoma peritonei”. Am J Surg Pathol. 2000;24:1447–64.CrossRefPubMed
24.
go back to reference De Nictolis M, Montironi R, Tommasoni S, Valli M, Pisani E, Fabris G, et al. Benign, borderline, and well-differentiated malignant intestinal mucinous tumors of the ovary: a clinicopathologic, histochemical, immunohistochemical, and nuclear quantitative study of 57 cases. Int J Gynecol Pathol. 1994;13:10–21.CrossRefPubMed De Nictolis M, Montironi R, Tommasoni S, Valli M, Pisani E, Fabris G, et al. Benign, borderline, and well-differentiated malignant intestinal mucinous tumors of the ovary: a clinicopathologic, histochemical, immunohistochemical, and nuclear quantitative study of 57 cases. Int J Gynecol Pathol. 1994;13:10–21.CrossRefPubMed
25.
go back to reference Salomon LJ, Lhommé C, Pautier P, Duvillard P, Morice P. Safety of simple cystectomy in patients with unilateral mucinous borderline tumors. Fertil Steril. 2006;85:1–4.CrossRef Salomon LJ, Lhommé C, Pautier P, Duvillard P, Morice P. Safety of simple cystectomy in patients with unilateral mucinous borderline tumors. Fertil Steril. 2006;85:1–4.CrossRef
26.
go back to reference Ramirez PT, Slomovitz BM, McQuinn L, Levenback C, Coleman RL, et al. Role of appendectomy at the time of primary surgery in patients with early-stage ovarian cancer. Gynecol Oncol. 2006;103:888–90.CrossRefPubMed Ramirez PT, Slomovitz BM, McQuinn L, Levenback C, Coleman RL, et al. Role of appendectomy at the time of primary surgery in patients with early-stage ovarian cancer. Gynecol Oncol. 2006;103:888–90.CrossRefPubMed
27.
Metadata
Title
Prognostic Factors of a Large Retrospective Series of Mucinous Borderline Tumors of the Ovary (Excluding Peritoneal Pseudomyxoma)
Authors
Martin Koskas, MD
Catherine Uzan, MD, PhD
Sebastien Gouy, MD
Patricia Pautier, MD
Catherine Lhommé, MD
Christine Haie-Meder, MD
Pierre Duvillard, MD
Philippe Morice, MD, PhD
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1293-8

Other articles of this Issue 1/2011

Annals of Surgical Oncology 1/2011 Go to the issue