Ovarian serous borderline tumors with invasive peritoneal implants

• Published in: Cancer Vol. 82; no. 6; pp. 1096 - 1103
• Main Authors: Gershenson, David M., Silva, Elvio G., Levy, Lawrence, Burke, Thomas W., Wolf, Judith K., Tornos, Carmen
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 15.03.1998; Wiley-Liss
• Subjects: Adult; Aged; Biological and medical sciences; borderline tumors; chemotherapy; Cystadenocarcinoma, Serous - pathology; Cystadenocarcinoma, Serous - surgery; Disease-Free Survival; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Ovary; Peritoneal Neoplasms - pathology; Retrospective Studies; surgery; Tumors; Human; Postoperative; Borderline; Prognosis; Doubling time; Adjuvant treatment; Cell biology; Metastasis; Malignant tumor; Female genital diseases; Ovarian diseases; Ovary; Surgery; Female; Survival curve; Peritoneum
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19980315)82:6<1096::AID-CNCR13>3.0.CO;2-1

BACKGROUND The objective of the current study was to update the authors' experience with patients with ovarian serous borderline tumors with invasive peritoneal implants to gain additional insight into the biologic behavior of these tumors and a better understanding of the effect of postoperative treatment. METHODS Thirty‐nine patients with ovarian serous borderline tumors with invasive peritoneal implants were identified through a retrospective review. Major endpoints selected for analysis were surgicopathologic response, time to recurrence, type of recurrence, progression free survival, and overall survival. Univariate and multivariate regression analyses also were performed. RESULTS Median follow‐up time was 111 months. Four of 7 evaluable patients who had second‐look surgery (57%) had a response to chemotherapy. Twelve of 39 patients (31%) either developed progressive disease or had a recurrence. The median time from date of diagnosis to recurrence was 24 months. In 10 of these 12 patients with a recurrence, tissue was available; 9 had invasive low grade serous carcinoma and 1 had a recurrent borderline tumor. Macroscopic residual disease was the only factor studied that had a significant effect on survival; patients with no macroscopic residual tumor had a significantly better survival than those with any macroscopic residual tumor (P < 0.01). In univariate regression analysis, macroscopic residual disease and the presence of frankly invasive implants were significant predictors of progression free survival. Platinum‐based chemotherapy was associated with a significantly shorter progression‐free survival. Only macroscopic residual tumor was a significant predictor of survival. CONCLUSIONS Greater than 30% of patients with ovarian serous borderline tumors with invasive peritoneal implants will develop progressive or recurrent tumor, most commonly serous carcinoma. The presence of macroscopic residual disease appears to be the major predictor of recurrence and survival. However, in this study, the authors were unable to elucidate the role of postoperative therapy or the criteria for selection of patients for such therapy. Cancer 1998;82:1096‐103. © 1998 American Cancer Society. Greater than 30% of patients with serous borderline tumors of the ovary with invasive peritoneal implants will develop progressive or recurrent tumor, most commonly serous carcinoma.