Borderline Ovarian Tumors – 10-year Clinical Series and
Literature Review
Freitag P., Jančárková N., Fischerová D., Cibula D., Živný J.
Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. J. Živný, DrSc. |
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Summary:
Objective: Analysis of 10-year clinical series of borderline ovarian tumors (BLT) and literature
review.
Design: Retrospective clinical study.
Setting: Department of Obstetrics and Gynaecology, 1st Medical Faculty, Charles University and
General Faculty Hospital, Prague.
Methods: Analysis of 38 patients from years 1994-2003 regarding age, histological types, tumor
duplicities, role of frozen section, Ca125 levels, operation methods, adjuvant treatment, relaps
occurrence, follow-up and survival.
Results: Median follow-up was 18.5 months (3-122), median age 51 (16-78). Histology: 23 serous,
12 mucinous (1 microinvasion), 2 cystadenofi bromas and 1 endosalpingiosis. 26 patients of
stage IA, 3 of IB, 6 of IC, 1 of IIA, 1 of IIC and 1 IIIB. 3 cases were underestimated by frozen section.
6 tumor duplicities were revealed. Ca 125 marker was elevated in 10/23 (43.5%) cases. 12
patients underwent conservative surgery, 3 of them with complete staging including lymphadenectomy.
26 patients had radical operation, 9 of them with full staging. No one lymphonode
was positive. 7 patients had primary laparoscopic approach, 6 had more than one operation.
Adjuvant chemotherapy was indicated in 3 cases: PTX-CBDCA (IC and IIC) and CBDCA-CFA
(IC). 4 patients were lost of evidence. 2/34 evaluated patients (5.9%) had a frank carcinoma
recurrence after 3 and 7 years. Both relapsed patients and all 34 evaluable patients live without
evidence of disease at present. Our results as well as literature date generate some controversies.
Do we need staging lymphadenectomy in all cases (inclusive T1a)? Which parameters
identify high-risk group and which patients will benefi t from adjuvant (and which one) therapy?
Are there not recurrencies of BLT rather second primary malignancies?
Conclusion: In spite of 2 recurrences in a group of 34 evaluated cases all patients live without
evidence of disease at present. Some management questions are therefore raised.
Key words:
borderline ovarian tumor
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