Ovarian Borderline Tumors: Features Predictive of Progression
Naomi Yoo, Natalia Buza, Jonathan D Black, Thomas J Rutherford, Fattaneh A Tavassoli. Yale New Haven Hospital, New Haven, CT
Background: Although the majority of ovarian borderline tumors (OBT) are clinically benign, predicting their progression remains a challenge. Tumor morphology and the extent of disease may help predict progression. To evaluate the impact of various features on progression, we reviewed a group of staged ovarian borderline tumors in our files.
Design: We identified 249 patients diagnosed with OBTs over a 22 year period (1983-2005). A subset of patients with positive implants, lymph nodes, and/or cytology were selected for slide and chart review. Various features (bilaterality, microinvasion, micropapillary features and extraovarian disease) were recorded and correlated with outcome and compared to the outcome of borderline tumors lacking these features.
Results: Of 249 identified patients, 72 (age range: 15 to 84 years) were selected for review. Among the 72 OBTs, 55 were serous, 12 mucinous and 5 seromucinous. Features evaluated included extraovarian implants (n=47, 9/47 invasive), nodal involvement (n=15), microinvasion (n=12), micropapillary/cribriform pattern (n=18), appendiceal mucinous lesion/pseudomyxoma peritonei (n=10) and/or positive cytology (n=39). Sixty of the 72 patients had follow-up (1 to 22 years). Eleven women died 5 to 22 years after diagnosis and 12 had recurrences requiring surgery. Of the 19 women who died and/or had a recurrence, 4 had an appendiceal tumor or pseudomyxoma peritonei at presentation, 2 microinvasive tumor, 6 micropapillary/cribriform lesions, 4 invasive implants, 8 non-invasive implants only, and 4 nodal implants. The two patients who died with disease both had micropapillary features in addition to either microinvasion, invasive implants and/or nodal involvement. In contrast, none of the OBTs lacking these features developed recurrences or proved fatal at last follow-up (1-21 years).
Conclusions: The presence of micropapillary pattern, microinvasion, invasive implants and lymph node involvement, particularly when they co-exist, is predictive of recurrence and progression. Adjuvant therapy could be useful for lesions with invasive implants or combined features to reduce chances of progression.
Category: Gynecologic & Obstetrics
Wednesday, March 6, 2013 9:30 AM
Poster Session V # 165, Wednesday Morning