Borderline tumours of the ovary: A cohort study of the Arbeitsgmeinschaft Gynäkologische Onkologie (AGO) Study Group

TY - JOUR

T1 - Borderline tumours of the ovary: A cohort study of the Arbeitsgmeinschaft Gynäkologische Onkologie (AGO) Study Group

AU - du Bois, Andreas

AU - Ewald-Riegler, Nina

AU - de Gregorio, Nikolaus

AU - Reuss, Alexander

AU - Mahner, Sven

AU - Fotopoulou, Christina

AU - Kommoss, Friedrich

AU - Schmalfeldt, Barbara

AU - Hilpert, Felix

AU - Fehm, Tanja

AU - Burges, Alexander

AU - Meier, Werner

AU - Hillemanns, Peter

AU - Hanker, Lars

AU - Hasenburg, Annette

AU - Strauss, Hans-Georg

AU - Hellriegel, Martin

AU - Wimberger, Pauline

AU - Keyver-Paik, Mignon-Denise

AU - Baumann, Klaus

AU - Canzler, Ulrich

AU - Wollschlaeger, Kerstin

AU - Forner, Dirk

AU - Pfisterer, Jacobus

AU - Schröder, Willibald

AU - Münstedt, Karsten

AU - Richter, Barbara

AU - Kommoss, Stefan

AU - Hauptmann, Steffen

AU - Arbeitsgmeinschaft Gynäkologische Onkologie (AGO) Study Group

N1 - Copyright © 2013 Elsevier Ltd. All rights reserved.

PY - 2013/5/1

Y1 - 2013/5/1

N2 - BACKGROUND: Borderline ovarian tumours (BOTs) are recognised as a unique entity of ovarian tumours that do not exert infiltrative destructive growth or stromal invasion. Prognosis of BOT is much better compared to the more common invasive epithelial ovarian cancer. Information regarding prognostic factors is inconclusive and no prospective studies exist that evaluate therapeutic strategies. We therefore started a retrospective-prospective cohort study to better understand BOT and identify scenarios in which future studies could be developed.METHODS: Consecutive patients with BOT treated between 1998 and 2008 in 24 German centres were analysed. The retrospective part of the study retrieved patients' data from hospital records and clinical tumour registries while active follow-up and an independent central pathology review were carried out prospectively.FINDINGS: BOT was confirmed in 950 patients, two thirds had serous BOT and 30.5% mucinous BOT. Most were diagnosed in stage I (82.3%); 7.6% and 10.1% had stages II and III, respectively. Overall, 74 patients (7.8%) experienced relapse and 43 (4.5%) died within the observation period. Multivariate analysis revealed higher stage, incomplete staging, tumour residuals, and organ preservation as independent prognostic factors for disease recurrence. Neither microinvasion nor micropapillary growth pattern showed any significant impact. Of 74 relapsed patients, 30% had malignant transformation to invasive ovarian cancer with five-year progression-free survival and overall survival of 12% and 50%, respectively.INTERPRETATION: Prognosis of BOT correlates with tumour-related as well as surgery-related factors. The balance between recurrence risk and organ preservation and fertility-sparing surgery is an important issue deserving further research.

AB - BACKGROUND: Borderline ovarian tumours (BOTs) are recognised as a unique entity of ovarian tumours that do not exert infiltrative destructive growth or stromal invasion. Prognosis of BOT is much better compared to the more common invasive epithelial ovarian cancer. Information regarding prognostic factors is inconclusive and no prospective studies exist that evaluate therapeutic strategies. We therefore started a retrospective-prospective cohort study to better understand BOT and identify scenarios in which future studies could be developed.METHODS: Consecutive patients with BOT treated between 1998 and 2008 in 24 German centres were analysed. The retrospective part of the study retrieved patients' data from hospital records and clinical tumour registries while active follow-up and an independent central pathology review were carried out prospectively.FINDINGS: BOT was confirmed in 950 patients, two thirds had serous BOT and 30.5% mucinous BOT. Most were diagnosed in stage I (82.3%); 7.6% and 10.1% had stages II and III, respectively. Overall, 74 patients (7.8%) experienced relapse and 43 (4.5%) died within the observation period. Multivariate analysis revealed higher stage, incomplete staging, tumour residuals, and organ preservation as independent prognostic factors for disease recurrence. Neither microinvasion nor micropapillary growth pattern showed any significant impact. Of 74 relapsed patients, 30% had malignant transformation to invasive ovarian cancer with five-year progression-free survival and overall survival of 12% and 50%, respectively.INTERPRETATION: Prognosis of BOT correlates with tumour-related as well as surgery-related factors. The balance between recurrence risk and organ preservation and fertility-sparing surgery is an important issue deserving further research.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cohort Studies

KW - Female

KW - Humans

KW - Kaplan-Meier Estimate

KW - Middle Aged

KW - Multivariate Analysis

KW - Neoplasm Invasiveness

KW - Neoplasm Recurrence, Local

KW - Neoplasm Staging

KW - Outcome Assessment (Health Care)

KW - Ovarian Neoplasms

KW - Ovary

KW - Prognosis

KW - Proportional Hazards Models

KW - Young Adult

U2 - 10.1016/j.ejca.2013.01.035

DO - 10.1016/j.ejca.2013.01.035

M3 - SCORING: Journal article

C2 - 23490647

VL - 49

SP - 1905

EP - 1914

JO - EUR J CANCER

JF - EUR J CANCER

SN - 0959-8049

IS - 8

ER -