Microinvasion in Ovarian Serous Tumor of Low Malignant Potential – Does It Matter?
Ramya P Masand, Anais Malpica, Preetha Ramalingam. Baylor College of Medicine, Houston, TX; MD Anderson Cancer Center, Houston, TX
Background: The significance of microinvasion (MI) in ovarian serous tumors of low malignant potential (OV-SLMP) is controversial. Early reports indicated that OV-SLMP with MI were of low stage with favorable outcome and associated with pregnancy. Subsequent studies have shown that MI in OV-SLMP was associated with higher stage disease, disease progression and/ or death due to disease. The aim of this study is to present our experience with cases of MI in typical OV-SLMP.
Design: 31 cases of OV-SLMP with MI and follow-up were retrieved from our files over a period of 16 years (1995-2010). Cases with micropapillary/cribriform pattern (MP/CP) were excluded. The following parameters were recorded: patients' (pts) age, pregnancy status, tumor size and laterality, ovarian surface involvement, focal vs multifocal MI, non-invasive vs invasive implants, stage of disease and outcome.
Results: Pts' age ranged from 18-82 yrs (median 47yrs). 2 pts were pregnant. Tumor size ranged from 2.5 cm to 25 cm (median 8.5cm); laterality was: left (6), right (9) and bilateral (16). Ovarian surface involvement was present in 10 cases and absent in 19 cases. In 2 cases, this information was not available. In 6 cases, MI was multifocal (MF), whereas in 25 cases, focal MI was seen. Cases were staged as follows: Stage I (11), Stage II (1), Stage III (12). No staging was performed in 7 cases. 7 patients had non-invasive implants (NI-IM), 6 had invasive implants (I-IM). Follow-up ranged from 6-261 months (median 58 months). 26 patients (84 %) were alive with no evidence of disease, 2 were alive with evidence of disease, 3 died of unrelated causes. One patient progressed to low grade serous carcinoma in 4 years, however she died of urothelial carcinoma.The 2 pregnant patients were alive with no evidence of disease at 27 and 106 months.
Conclusions: OV-SLMP with MI appears to be associated with bilaterality, ovarian surface involvement and advanced stage disease. Focal versus MF MI does not appear to correlate with clinical outcome. Only 2 pregnant patients were present in our study and had favorable outcomes as previously reported. An unexpected finding noted in our study was a higher incidence (46%) of invasive implants in these cases. Additional studies will be necessary to determine if this latter finding is truly associated with OV-SLMP with MI.
Category: Gynecologic & Obstetrics
Wednesday, March 6, 2013 9:30 AM
Poster Session V # 167, Wednesday Morning