Borderline-Tumoren des Ovars – eine systematische Übersicht

Zusammenfassung

Für diese systematische Übersicht wurden Arbeiten in deutscher und englischer Sprache über eine MEDLINE-Suche identifiziert. Zusätzlich wurden die Literaturangaben der Reviews durchgesehen und so weitere Arbeiten identifiziert. Daraus wurden etwa 200 Publikationen für die weitere Bearbeitung nach Screening des Titels und des Abstracts ausgewählt. Die Daten wurden mittels eines standardisierten Fragebogens extrahiert und folgenden Fragestellungen zugeordnet: Epidemiologie und Risikofaktoren, Pathogenese und Prognosefaktoren, Klinik und Therapie sowie onkologischer und reproduktionsmedizinischer Verlauf. Diese Übersicht stellt die derzeit aktuellste und kompletteste Übersicht zu den Borderline-Tumoren dar und bietet die Grundlage für Therapieberatung und Entscheidung in der Behandlung betroffener Patientinnen.

Abstract

This systematic review is based on a MEDLINE search including English and German papers. In addition, hand search of all reviews was performed and articles were added. Overall, about 200 articles were identified and screened. Data extraction was performed by a standardized questionnaire and data were sorted according to predefined points of interest: epidemiology and risk factors, clinics and therapy, and oncologic long-term outcome and reproductive outcome. This review presents the most comprehensive data collection currently available and may provide a basis for patient counselling.

Schlüsselwörter

Borderline‐Tumor - low malignant potential - Prognosefaktoren - Outcome

Key words

borderline tumors - low malignant potential - prognostic factors - outcome

Literatur

• 1 Taylor Jr. H C. Malignant and semimalignant tumors of the ovary.  Surg Gynecol Obstet. 1929;  48 204-230
• 2 Seidman J D, Soslow R A, Vang R et al. Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrative images.  Hum Pathol. 2004;  35 918-933
• 3 Bell D A, Longacre T A, Prat J et al. Serous borderline (low malignant potential, atypical proliferative) ovarian tumors: workshop perspectives.  Hum Pathol. 2004;  35 934-948
• 4 Silverberg S G, Bell D A, Kurman R J et al. Borderline ovarian tumors: key points and workshop summary.  Hum Pathol. 2004;  35 910-917
• 5 Seidman J D, Kurman R J. Ovarian serous borderline tumors: A critical review of the literature with emphasis on prognostic indicators.  Hum Pathol. 2000;  31 539-557
• 6 Bell D A, Scully R E. Ovarian serous borderline tumors with stromal microinvasion: a report of 21 cases.  Human Pathol. 1990;  21 397-403
• 7 Sherman M E, Mink P J, Curtis R et al. Survival among women with borderline ovarian tumors and ovarian carcinoma: A population-based Analysis.  Cancer. 2004;  100 1045-1052
• 8 Cusido M, Balaguero L, Hernandez G et al. Results of the national survey of borderline ovarian tumors in Spain.  Gynecol Oncol. 2007;  104 617-622
• 9 Akeson M, Zetterqvist B M, Dahllops K et al. Population-based cohort follow-up study of all patients operated for borderline ovarian tumor in western Sweden during an 11-year period.  Int J Gynecol Cancer. 2008;  18 453-459
• 10 Kaern J, Tropé C G, Abeler V M. A retrospective study of 370 borderline tumors of the ovary treated at the Norwegian Radium Hospital from 1970 to 1982.  Cancer. 1993;  71 1810-1820
• 11 Park J-Y, Kim D-Y, Kim J-H et al. Surgical management of borderline ovarian tumors: The role of fertility-sparing surgery.  Gynecol Oncol. 2009;  DOI: 10.1016/2008:12034
• 12 Fauvet R, Boccara J, Dufournet C et al. Laparoscopic management of borderline ovarian tumors: results of a French multicenter study.  Ann Oncol. 2005;  16 403-410
• 13 Zanetta G, Rota S, Chiari S et al. Behaviour of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study.  J Clin Oncol. 2001;  19 2658-2664
• 14 Trope C, Kaern J, Vergote I B et al. Are borderline tumors of the ovary overtreated both surgically and systemically? A review of four prospective randomized trials including 253 patients with borderline tumors.  Gynecol Oncol. 1993;  51 236-243
• 15 Longacre T A, McKenney J K, Tazelaar H D et al. Ovarian tumors of low malignant potential (borderline tumors).  Am J Surg Pathol. 2005;  29 707-723
• 16 Ren J, Peng Z, Yang K. A clinicopathologic multivariate analysis affecting recurrence of borderline ovarian tumors.  Gynecol Oncol. 2008;  110 162-167
• 17 Leake J F, Currie J L, Rosenshein N B et al. Long-term follow-up of serous ovarian tumors of low malignant potential.  Gynecol Oncol. 1992;  47 150-158
• 18 Morice P, Camatte S, El Hassan J et al. Clinical outcome and fertility after conservative treatment of ovarian borderline tumors.  Fertil Steril. 2001;  75 92-96
• 19 De Iaco P, Ferrero A, Rosati F et al. Behaviour of ovarian tumors of low malignant potential treated with conservative surgery.  Eur J Surg Oncol. 2008;  DOI: 10.1016/j.ejso.2008.09.011
• 20 Buttin B, Herzog T J, Powell M A et al. Epithelial ovarian tumors of low malignant potential: The role of microinvasion.  Obstet Gyneccol. 2002;  99 11-17
• 21 Romangnolo C, Gadducci A, Sartori E et al. Management of borderline ovarian tumors: Results of an Italian multicenter study.  Gynecol Oncol. 2006;  101 255-260
• 22 Bostwick D G, Tazelaar H D, Ballon S C et al. Ovarian epithelial tumors of borderline malignancy.  Cancer. 1986;  58 2052-2065
• 23 Prat J, de Nictolis M. Serous borderline tumors of the ovary: A long-term follow-up study of 137 cases, including 18 with a micropapillary pattern and 20 with microinvasion.  Am J Pathol. 2002;  26 1111-1128
• 24 Yokoyama Y, Moriya T, Takano T et al. Clinical outcome and risk factors for recurrence in borderline ovarian tumours.  Br J Cancer. 2006;  94 1586-1591
• 25 Kuoppala T, Heinola M, Aine R et al. Serous and mucinous borderline tumors of the ovary: A clinicopathologic and DNA-ploidy study of 102 cases.  Int J Gynecol Cancer. 1996;  6 302-308
• 26 Chambers J T, Merino M J, Kohorn E I et al. Borderline ovarian tumors.  Am J Obstet Gynecol. 1988;  159 1088-1094
• 27 Winter W E, Kucera P R, Rodgers W et al. Surgical staging in patients with tumors of low malignant potential.  Obstet Gynecol. 2002;  100 671-676
• 28 Liapis A, Bakalianou K, Iavazzo C et al. A retrospective analysis of borderline ovarian tumors in a Greek university hospital.  Eur J Gynecol Oncol. 2008;  29 383-385
• 29 Gotlieb W H, Flikker S, Davidson B et al. Borderline tumors of the ovary.  Cancer. 1998;  82 141-146
• 30 Rice L W, Berkowitz R S, Mark S D et al. Epithelial ovarian tumors of borderline malignancy.  Gynecol Oncol. 1990;  39 195-198
• 31 Papadimitriou D S, Martin-Hirsch P, Kitchener H C et al. Recurrent borderline ovarian tumors after conservative management in women wishing to retain their fertility.  Eur J Gynecol Oncol. 1999;  20 94-97
• 32 Kennedy A W, Hart W R. Ovarian papillary serous tumors of low malignant potential (serous borderline tumors): A long follow-up study, including patients with microinvasion, lymph node metastasis and transformation to invasive serous carcinoma.  Cancer. 1996;  78 278-286
• 33 Kliman L, Rome R M, Fortune D W. Low malignant potential tumors of the ovary: a study of 76 cases.  Obstet Gynecol. 1986;  68 338-344
• 34 Donnez J, Munschke A, Berliers M et al. Safety of conservative management and fertility outcome in women with borderline tumors of the ovary.  Fertil Steril. 2003;  79 1216-1221
• 35 Tasker M, Langley F A. The outlook for women with borderline epithelial tumours of the ovary.  BJOG. 1985;  92 969-973
• 36 Nakashima N, Nagasaka T, Oiwa N et al. Ovarian epithelial tumors of borderline malignancy in Japan.  Gynecol Oncol. 1990;  38 90-98
• 37 Kumpulainen S, Kuoppala T, Leminen A et al. Surgical staging, treatment, and follow-up of borderline tumors in different hospital categories: a prospective nationwide survey in Finland.  Acta Obstet Gynecol. 2007;  86 610-614
• 38 Nation J G, Krepart G V. Ovarian carcinoma of low malignant potential: staging and treatment.  Am J Obstet Gynecol. 1986;  154 290-293
• 39 Julian C G, Woodruff D. The biologic behavior of low-grade papillary serous carcinoma of the ovary.  Obstet Gynecol. 1972;  40 860-867
• 40 Maneo A, Vignali M, Chiari S et al. Are borderline tumors of the ovary safely treated by laparoscopy?.  Gynecol Oncol. 2004;  94 387-392
• 41 Boran N, Cil A P, Tulunay G et al. Fertility and recurrence results of conservative surgery for borderline ovarian tumors.  Gynecol Oncol. 2005;  97 845-851
• 42 Guerrieri C, Hogberg T, Wingren S et al. Mucinous borderline and malignant tumors of the ovary.  Cancer. 1994;  74 2329-2340
• 43 McKenney J K, Balzer B L, Longacre T A. Patterns of stromal invasion in ovarian serous tumors of low malignant potential (borderline tumors): A reevaluation of the concept of stromal microinvasion.  Am J Surg Path. 2006;  30 1209-1221
• 44 Pirimoglu Z M, Afsin Y, Guzelmeric K, Yilmaz M et al. Is it necessary to do retroperitoneal evaluation in borderline epithelial ovarian tumors.  Arch Gynecol Obstet. 2008;  277 411-414
• 45 Smith Sehdev A E, Sehdev P S, Kurman R J. Noninvasive and invasive micropapillary (low-grade) serous carcinoma of the ovary. A clinicopathologic analysis of 135 cases.  Am J Surg Pathol. 2003;  27 725-736
• 46 Allison K H, Swisher E M, Kerkering K M et al. Defining an appropriate threshold for the diagnosis of serous borderline tumor of the ovary: When is a full staging procedure unnecessary?.  Int J Gynecol Path. 2007;  27 10-17
• 47 Katzenstein A L A, Mazur M T, Morgan T E et al. Proliferative serous tumors of the ovary.  Am J Surg Pathol. 1978;  5 339-355
• 48 Bristow R E, Gossett D R, Shook D R et al. Micropapillary serous ovarian carcinoma: Surgical management and clinical outcome.  Gynecol Oncol. 2002;  86 163-170
• 49 Fort M G, Pierce V K, Saigo P E et al. Evidence for the efficacy of adjuvant therapy in epithelial ovarian tumors of low malignant potential.  Gynecol Oncol. 1989;  32 269-272
• 50 Hogg R, Scurry J, Kim S-N et al. Microinvasion links ovarian serous borderline tumor and grade I invasive carcinoma.  Gynecol Oncol. 2007;  106 44-51
• 51 Engelen M J A, de Bruijn H W A, Hollema H et al. Serum CA 125, carcinoembryonic antigen, and CA 19-9 as tumor markers in borderline ovarian tumors.  Gynecol Oncol. 2000;  78 16-20
• 52 Morris R T, Gershenson D M, Silva E G et al. Outcome and reproductive function after conservative surgery for borderline ovarian tumors.  Obstet Gynecol. 2000;  95 541-547
• 53 Camatte S, Morice P, Atallah D et al. Lymph node disorders and prognostic value of nodal involvement in patients treated for a borderline ovarian tumor: An analysis of a series of 42 lymphadenectomies.  J Am Coll Surg. 2002;  195 332-338
• 54 Casey A C, Bell D A, Lage J M et al. Epithelial ovarian tumors of borderline malignancy: Long-term follow-up.  Gynecol Oncol. 1993;  50 316-322
• 55 Rao G G, Skinner E N, Gehring P A et al. Fertility-sparing surgergy for ovarian low malignant potential tumors.  Gynecol Onkol. 2005;  98 263-266
• 56 Betash N, Modares M, Abolhasani M et al. Borderline ovarian tumours: clinical analysis of 38 cases.  J Obstet Gynaecol. 2004;  24 157-160
• 57 Lim-Tan S K, Cajigas H E, Sculy R E. Ovarian cystectomy for serous borderline tumors: a follow-up study of 35 cases.  Obstet Gynecol. 1988;  72 775-781
• 58 Leake J F, Rader J S, Woodruff J D et al. Retroperitoneal lymphatic involvement with epithelial ovarian tumors of low malignant potential.  Gynecol Oncol. 1991;  42 124-130
• 59 Massad L S, Hunter V J, Szpak C A et al. Epithelial ovarian tumors of low malignant potential.  Obstet Gynecol. 1991;  78 1027-1031
• 60 Demeter A, Csapó Z, Szánthó A et al. A retrospective study of 27 ovarian tumors of low malignant potential.  Eur J Gynaecol Oncol. 2002;  23 415-418
• 61 Darai E, Teboul J, Fauconnier A et al. Management and outcome of borderline ovarian tumors incidentally discovered at or after laparoscopy.  Acta Obstet Gynecol Scand. 1998;  77 451-457
• 62 Chan J K, Lin Y G, Loizzi V et al. Borderline ovarian tumors in reproductive-age women. Fertility-sparing surgery and outcome.  J Reprod Med. 2003;  48 756-760
• 63 Laurent I, Uzan C, Gouy S et al. Results after conservative treatment of serous borderline tumors of the ovary with a micropapillary pattern.  Ann Surg Oncol. 2008;  15 3561-3566
• 64 Shappell H W, Riopel M A, Smith Sehdev A E et al. Diagnostic criteria and behavior of ovarian seromucinous (endocervical-type mucinous and mixed cell-type) tumors.  Am J Surg Path. 2002;  26 1529-1541
• 65 O'Quinn A G, Hannigan E V. Epithelial ovarian neoplasms of low malignant potential.  Gynecol Oncol. 1985;  21 177-185
• 66 Nezhat F R, Ezzati M, Chuang L et al. Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome.  Am J Obstet Gynecol. 2009;  200 83.e1-83.e6
• 67 Morice P, Camatte S, Rey A et al. Prognostic factors for patients with advanced stage serous borderline tumors of the ovary.  Ann Oncol. 2003;  14 592-598
• 68 Silva E G, Gershenson D M, Malpica A et al. The recurrence and the overall survival rates of ovarian serous borderline neoplasms with noninvasive implants is time dependent.  Am J Surg Pathol. 2006;  30 1367-1371
• 69 Gershenson D M, Silva E G, Tortolero-Luna G et al. Serous borderline tumors of ovarian with noninvasive peritoneal implants.  Cancer. 1998;  83 2157-2163
• 70 Bell D A, Weinstock M A, Scully R E. Peritoneal implants of ovarian serous borderline tumors.  Cancer. 1988;  62 2212-2222
• 71 Gershenson D M, Silva E G, Levy L et al. Ovarian serous borderline tumors with invasive peritoneal implants.  Cancer. 1998;  82 1096-1103
• 72 Barakat R R, Benjamin I, Lewis Jr. J L et al. Platinum-based chemotherapy for advanced-stage ovarian carcinoma malignant potential.  Gynecol Oncol. 1995;  59 390-393
• 73 Camatte S, Morice P, Pautier P et al. Fertility results after conservative treatment of advanced stage serous borderline tumor of the ovary.  BJOG. 2002;  109 376-380
• 74 Lackmann F, Carey M S, Kirk M E et al. Surgery as sole treatment for serous borderline tumors of the ovary with noninvasive implants.  Gynecol Oncol. 2003;  90 407-412
• 75 Vandeput I, Amant F, Vergote I. Peritoneal recurrences might be less common in advanced stage serous borderline ovarian tumors that were treated by laparotomy.  Gynecol Oncol. 2005;  98 523 , (letter)
  
• 76 Deffieux X, Morice P, Camatte S et al. Results after laparoscopic management of serous borderline tumor of the ovary with peritoneal implants.  Gynecol Oncol. 2005;  97 84-89
• 77 Nijman H W, Burger C W, Baak J P A et al. Borderline malignancy of the ovary and controlled hyperstimulation, a report of 2 cases.  Eur J Cancer. 1992;  28 A 1971-1973
• 78 Barnhill D R, Kurman R J, Brady M F et al. Preliminary analysis of the behavior of stage I ovarian serous tumors of low malignant potential: A Gynecologic Oncology Group Study.  J Clin Oncol. 1995;  13 2752-2756
• 79 Desfeux P, Camatte S, Chatellier G et al. Impact of surgical approach on the management of macroscopic early ovarian borderline tumors.  Gynecol Oncol. 2005;  98 390-395
• 80 Odegaard E, Staff A C, Langebrekke A et al. Surgery of borderline tumors of the ovary; retrospective comparison of short-term outcome after laparoscopy or laparotomy.  Acta Obstet Gynecol. 2007;  86 620-626
• 81 Camatte S, Morice P, Thoury A et al. Impact of surgical staging in patients with macroscopic “stage I” ovarian borderline tumours: analysis of a continuous series of 101 cases.  Eur J Cancer. 2004;  40 1842-1849
• 82 Ji H, Yliskoski M, Anttila M et al. Management of stage-I borderline ovarian tumors.  Int J Gynecol Oncol. 1996;  54 37-44
• 83 Tazelaar H D, Bostwick D G, Ballon S C et al. Conservative treatment of borderline ovarian tumors.  Obstet Gynecol. 1985;  66 417-422
• 84 Creasman W T, Park R, Norris H et al. Stage I borderline ovarian tumors.  Obstet Gynecol. 1982;  59 93-96
• 85 Tinelli F G, Tinelli R, La Grotta F et al. Pregnancy outcome and recurrence after conservative laparoscopic surgery for borderline ovarian tumors.  Acta Obstet Gynecol. 2007;  86 81-87
• 86 Marcickiewicz J, Brannstrom M. Fertility preserving surgical treatment of borderline ovarian tumour: long-term consequence for fertility and recurrence.  Acta Obstet Gynecol. 2006;  85 1496-1500
• 87 Seracchioli R, Venturoli S, Colombo F M et al. Fertility and tumor recurrence rate after conservative laparoscopic management of young women with early-stage borderline ovarian tumors.  Fertil Steril. 2001;  76 999-1004
• 88 Fasouliotis S J, Davis O, Schattman G et al. Safety and efficacy of infertility treatment after conservative management of borderline ovarian tumors: a preliminary report.  Fertil Steril. 2004;  82 568-572
• 89 Skirnisdottir I, Garmo H, Wilander E et al. Borderline ovarian tumors in Sweden 1960–2005: Trends in incidence and age at diagnosis compared to ovarian cancer.  Int J Cancer. 2008;  123 1897-1901
• 90 Iscovich J, Shushan A, Schenker J G et al. The incidence of borderline ovarian tumors in Israel. A population-based study.  Cancer. 1998;  82 147-151
• 91 Levi F, La Vecchia C, Randimbison L et al. Borderline ovarian tumors in Vaud, Switzerland: Incidence, survival and second neoplasms.  Br J Cancer. 1999;  79 4-6
• 92 Mink P J, Sherman M E, Devesa S S. Incidence patterns of invasive and borderline ovarian tumors among white women and black women in the United States: Results from the SEER program, 1978–1998.  Cancer. 2002;  95 2380-2389
• 93 Heintz A P M, Odicino F, Maisonneuve P et al. Carcinoma of the ovary. Pecorelli S 26th annual report on the results of treatment in gynecological cancer. Int J Gynecol Obstet 2006 95 (Suppl. 1): 161-192
• 94 Pal T, Permuth-Wey J, Betts J A et al. BRCA1 and BRCA2 mutations account for a large proportion of ovarian carcinoma cases.  Cancer. 2005;  104 2807-2816
• 95 Gotlieb W H, Chetrit A, Menczer J et al. Demographic and genetic characteristics of patients with borderline ovarian tumors as compared to early stage invasive ovarian cancer.  Gynecol Oncol. 2005;  97 780-783
• 96 Gram I T, Braaten T, Adami H-O et al. Cigarette smoking and risk of borderline and invasive epithelial ovarian cancer.  Int J Cancer. 2008;  122 647-652
• 97 Jordan S J, Green A C, Whiteman D C for the Australian Cancer Study (Ovarian Cancer), and the Australian Ovarian Cancer Study Group et al. Risk factors for benign, borderline and invasive mucinous ovarian tumors: Epidemiological evidence of a neoplastic continuum.  Gynecol Oncol. 2007;  107 223-230
• 98 Collaborative Group of Epidemiological Studies of Ovarian Cancer . Ovarian cancer and oral contraceptives; collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87303 controls.  Lancet. 2008;  371 303-314
• 99 Ness R B, Cramer D W, Goodmann M T et al. Infertility, fertility drugs, and ovarian cancer: A pooled analysis of case-control studies.  Am J Epidemiol. 2002;  155 217-224
• 100 Zreik T G, Ayoub C M, Hannoun A et al. Fertility drugs and risk of ovarian cancer: Dispelling the myth.  Curr Opin Obstst Gynecol. 2008;  20 313-319
• 101 Rossing M A, Tang M T C, Flagg E W et al. A case-control study of ovarian cancer in relation to infertility and the use of ovulation-inducing drugs.  Am J Epidemiol. 2004;  160 1070-1078
• 102 Cetin I, Cozzi V, Antonazzo P. Infertility as a cancer risk factor. A review.  Placenta. 2008;  29 S169-S177
• 103 Parazzini F, Negri E, La Vecchia C et al. Treatment for fertility and risk of ovarian tumors of borderline malignancy.  Gynecol Oncol. 1998;  68 226-228
• 104 Rossing M A, Daling J R, Weiss N S et al. Ovarian tumors in a cohort of infertile women.  N Engl J Med. 1994;  331 771-776
• 105 Jensen A, Sharif H, Frederiksen K et al. Use of fertility drugs and risk of ovarian cancer: Danish population based cohort study.  BMJ. 2009;  338 b249 DOI: 10.1136/bmj.b249
• 106 Venn A, Watson L, Bruinsma F et al. Risk of cancer after use of fertility drugs with in-vitro fertilization.  Lancet. 1999;  354 1586-1590
• 107 Landen Jr. C N, Birrer M J, Sood A K. Early events in the pathogenesis of epithelial ovarian cancer.  J Clin Oncol. 2008;  26 995-1005
• 108 Levanon K, Crum C, Drapkin R. New insights into the pathogenesis of serous ovarian cancer and its clinical impact.  J Clin Oncol. 2008;  26 1-10
• 109 Kurman R J, Visvanathan K, Roden R et al. Early detection and treatment of ovarian cancer: Shifting from early stage to minimal volume of disease based on a new model of carcinogenesis.  Am J Obstet Gynecol. 2008;  198 351-356
• 110 Kurman R J, Shih I-M. Pathogenesis of ovarian cancer: Lessons from morphology and molecular biology and their clinical implications.  Int J Gynecol Pathol. 2008;  27 151-160
• 111 Olsen C M, Green A C, Nagle C M et al. Epithelial ovarian cancer: testing the “androgen hypothesis”.  Endocrine-Related Cancer. 2008;  15 1061-1068
• 112 Berchuck A, Heron K A, Carney M E et al. Frequency of germline and somatic BRCA1 mutations in ovarian cancer.  Clin Cancer Res. 1998;  4 2433-2437
• 113 Merajver S D, Pham T M, Caduff R F et al. Somatic mutations in the BRCA1 gene in sporadic ovarian tumors.  Nat Genet. 1995;  9 439-443
• 114 Thrall M, Gallion H H, Kryscio R et al. BRCA1 expression in a large series of sporadic ovarian carcinomas: a Gynecologic Oncology Group study.  Int J Gynecol Cancer. 2006;  16 166-171
• 115 Zheng W, Luo F, Lu J J et al. Reduction of BRCA1 expression in sporadic ovarian cancer.  Gynecol Oncol. 2000;  76 294-300
• 116 Russel P A, Pharoah P D, De Foy K et al. Frequent loss of BRCA1 mRNA and protein expression in sporadic ovarian cancers.  Int J Cancer. 2000;  87 317-321
• 117 Wang C. Expression of BRCA1 protein in benign borderline, and malignant epithelial ovarian neoplasms and its relationship to methylation and allelic loss of the BRCA1 gene.  J Pathol. 2004;  202 215-223
• 118 Plaxe S C. Epidemiology of low-grade serous ovarian cancer.  Am J Obstet Gynecol. 2008;  198 459.e1-459.e9
• 119 Meinhold-Heerlein I, Bauerschlag D, Hilpert F et al. Molecular and prognostic distinction between serous ovarian carcinoma of varying grade and malignant potential.  Oncogene. 2005;  24 1053-1065
• 120 Bonome T, Lee J Y, Park D C et al. Expression profiling of serous low malignant potential, low-grade, and high-grade tumors of the ovary.  Cancer Res. 2005;  65 10602-10612
• 121 Gershenson D M, Wong K K. The continuum of serous tumors of low malignant potential and low-grade serous carcinomas of the ovary. Educational Book.  Am Soc Clinical Oncol. 2007;  313-317
• 122 Piek J M, van Diest P J, Zweemer R P et al. Dysplastic changes in prophylactically removed fallopian tubes of women predisposed to developing ovarian cancer.  J Pathol. 2001;  195 451-456
• 123 Lee Y, Miron A, Drapkin R et al. A candidate precursor to serous carcinoma that originates in the distal fallopian tube.  J Pathol. 2007;  211 26-35
• 124 Jarboe E, Folkins A, Nucci M R et al. Serous carcinogenesis in the fallopian tube: A descriptive classification.  Int J Gynecol Pathol. 2008;  27 1-9
• 125 Palomba S, Zupi E, Russo T et al. Comparison of two fertility-sparing approaches for bilateral borderline tumours: a randomized controlled study.  Human Rep. 2007;  22 578-585
• 126 Chang S-J, Ryu H-S, Chang K-H et al. Prognostic significance of the micropapillary pattern in patients with serous borderline ovarian tumors.  Acta Obstet Gynecol. 2008;  87 478-481
• 127 Kaern J, Trope C G, Kristensen G B et al. DNA ploidy; the most important prognostic factor in patients with borderline tumors of the ovary.  Int J Gynecol Cancer. 1993;  3 349-358
• 128 Lai C-H, Hsueh S, Chang T-C et al. The role of DNA flow cytometry in borderline malignant ovarian tumors.  Cancer. 1996;  78 794-802
• 129 Meyer J S, Gersell D J, Yim S Y. Cell proliferation in ovarian carcinoma: Superior accuracy of S-phase fraction (SPF) by DNA labelling index versus flow cytometric SPF, lack of independent prognostic power for SPF and DNA ploidy, and limited effect of SPF on tumor growth rate.  Gynecol Oncol. 2001;  81 466-476
• 130 Verbruggen M B, van Diest P J, Baak J P et al. The prognostic and clinical value of morphometric and DNA cytometry in borderline ovarian tumors: a prospective study.  Int J Gynecol Pathol. 2009;  28 35-40
• 131 Snider D D, Stuart G C E, Nation J G et al. Evaluation of surgical staging in stage I low malignant potential ovarian tumors.  Gynecol Oncol. 1991;  40 129-132
• 132 Fortin A, Morice P, Thoury A et al. Impact of infertility drugs after treatment of borderline ovarian tumors: results of a retrospective multicenter study.  Fertil Steril. 2007;  87 591-596
• 133 Brun J-L, Cortez A, Rouzier R et al. Factors influencing the use and accuracy of frozen section diagnosis of epithelial ovarian tumors.  Am J Obstet Gynecol. 2006;  199 244.e1-244.e7
• 134 Attanucci C A, Ball H G, Zweizig S L et al. Differences in symptoms between patients with benign and malignant ovarian neoplasms.  Am J Obstet Gynecol. 2004;  190 1435-1437
• 135 Vine M F, Calingaert B, Berchuck A et al. Characterization of prediagnostic symptoms among primary epithelial ovarian cancer cases and controls.  Gynecol Oncol. 2003;  90 75-82
• 136 Vine M, Ness R B, Calingaert B et al. Types and duration of symptoms prior to diagnosis of invasive or borderline ovarian tumor.  Gynecol Oncol. 2001;  83 466-471
• 137 Webb P M, Purdie D M, Grover S et al. Symptoms and diagnosis of borderline, early and advanced epithelial ovarian cancer.  Gynecol Oncol. 2004;  92 232-239
• 138 Economou A, Panagopoulos P, Koutras I et al. A retrospective study of 32 borderline ovarian tumors: The experience of a non-specialized centre.  Eur J Gynaecol Oncol. 2005;  26 196-198
• 139 DeSouza N M, O'Neill R, McIndoe G A et al. Borderline tumors of the ovary: CT and MRI features and tumor markers in differentiation from stage I disease.  AJR. 2005;  184 999-1003
• 140 Yazigi R, Sandstad J, Munoz A K. Primary staging in ovarian tumors of low malignant potential.  Gynecol Oncol. 1988;  31 402-408
• 141 Nikrui N. Survey of clinical behavior of patients with borderline epithelial tumors of the ovary.  Gynecol Oncol. 1981;  12 107-119
• 142 Eltabbakh G H, Yadev P R, Morgan A. Clinical picture of women with early stage ovarian cancer.  Gynecol Oncol. 1999;  75 476-479
• 143 Sykes P H, Quinn M A, Rome R M. Ovarian tumors of low malignant potential: A retrospective study of 234 patients.  Int Gynecol Cancer. 1997;  7 218-226
• 144 Tamakoshi K, Kikkawa F, Shibata K et al. Clinical value of CA 125, CA 19-9, CEA, CA 72-4 and TPA in borderline ovarian tumor.  Gynecol Oncol. 1996;  62 67-72
• 145 Schutter E M- J, Davelaar E M, van Kamp G J et al. The differential diagnostic potential of a panel of tumor markers (CA 125, CA 15-3, and CA 72-4 antigens) in patients with a pelvic mass.  Am J Obstet Gynecol. 2002;  187 385-392
• 146 Gotlieb W H, Soriano D, Achiron R et al. CA 125 measurement and ultrasonography in borderline tumors of the ovary.  Am J Obstet Gynecol. 2000;  183 541-546
• 147 Benedet J L, Bender H, Jones III H et al. FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology.  Int J Gynaecol Obstet. 2000;  70 209-262
• 148 du Bois A, Burges A, Emons G et al. In: Schmalfeldt B, Pfisterer J, Hrsg. Interdisziplinäre S2 k-Leitlinie für die Diagnostik und Therapie maligner Ovarialtumoren 2007, Kommission Ovar der AGO e. V. München; W. Zuckschwerdt Verlag 2007
• 149 Cadron I, Leunen K, van Gorp T et al. Management of borderline neoplasms.  J Clin Oncol. 2007;  25 2928-2937
• 150 Verleye L, Ottevanger P B, Graaf W et al. EORTC-GCG process quality indicators for ovarian cancer surgery. Gynaecological Cancer Group (GCG) of European Organisation for Research and Treatment of Cancer (EORTC).  Eur J Cancer. 2009;  45 517-526
• 151 du Bois A, Rochon J, Pfisterer J et al. Variations in institutional infrastructure, physician specialization and experience, and outcome in ovarian cancer: A systematic review.  Gynecol Oncol. 2008;  112 422-436
• 152 Lin P S, Gershenson D M, Bevers M W et al. The current status of surgical staging of ovarian serous borderline tumors.  Cancer. 1999;  85 905-911
• 153 Menzin A W, Gal D, Lovecchio J L. Contemporary surgical management of borderline ovarian tumors: A survey of the society of gynecologic oncologists.  Gynecol Oncol. 2000;  78 7-9
• 154 Olsen C M, Green A C, Nagle C M et al. Epithelial ovarian cancer: testing the “androgen hypothesis”.  Endocrine-Related Cancer. 2008;  15 1061-1068
• 155 Di Re F, Paladini D, Fontanelli R et al. Surgical staging for epithelial ovarian tumors of low malignant potential.  Int J Gynecol Cancer. 1994;  4 310-314
• 156 McKenney J K, Balzer J K, Longacre T A. Lymph node involvement in ovarian serous tumors of low malignant potential (borderline tumors).  Am J Surg Path. 2006;  30 614-624
• 157 Wingo S N, Knowles L M, Carrick K S et al. Retrospective cohort study of surgical staging for ovarian low malignant potential tumors.  Am J Obstet Gynecol. 2006;  194 20-22
• 158 Tempfer C B, Polterauer S, Bentz E-K et al. Accuracy of intraoperative frozen section analysis in borderline tumors of the ovary: A retrospective analysis of 96 cases and review of the literature.  Gynecol Oncol. 2007;  107 248-252
• 159 Wasinghon P, Suthhippintawong C, Tuipae S. The accuracy of intraoperative frozen sections in the diagnosis of ovarian tumors.  J Med Assoc Thai. 2008;  91 1791-1795
• 160 Rakhshan A, Zham H, Kazempour M. Accuracy of frozen section diagnosis in ovarian masses: experience at a tertiary oncology center.  Arch Gynecol Obstet. 2008;  DOI: 10.1007/s00404-008-0899-6
• 161 Yarandi F, Eftekhar Z, Izadi-Mod N et al. Accuracy of intraoperative frozen section in the diagnosis of ovarian tumors.  Aus NZ J Obstet Gynecol. 2008;  48 438-441
• 162 Twaalfhoven F C M, Peters A A W, Trimbos J B et al. The accuracy of frozen section diagnosis of ovarian tumors.  Gynecol Oncol. 1991;  41 189-192
• 163 Rose P G, Rubin R B, Nelson B E et al. Accuracy of frozen-section (intraoperative consultation) diagnosis of ovarian tumors.  Am J Obstet Gynecol. 1994;  171 823-826
• 164 Yeo E L, Yu K M, Poddar N C et al. The accuracy of intraoperative frozen section in the diagnosis of ovarian tumors.  J Obstet Gynaecol Res. 1998;  24 189-195
• 165 Pinto P B C, Andrade A L A, Derchain S F M. Accuracy of intraoperative frozen section diagnosis of ovarian tumors.  Gynecol Oncol. 2001;  81 230-232
• 166 Trimbos J B, Vergote I, Bolis G et al. Impact of adjuvant chemotherapy and surgical staging in early-stage ovarian carcinoma: European Organisation for Research and Treatment of Cancer-Adjuvant ChemoTherapy in Ovarian Neoplasm trial.  J Natl Cancer Inst. 2003;  95 113-125
• 167 Zanetta G, Rota S, Chiari S et al. The accuracy of staging: an important prognostic determinator in stage I ovarian carcinoma.  Ann Oncol. 1998;  9 1097-1101
• 168 Torrent Colomer A, Martin Jiminez A, Bover Barcelo M I. Laparoscopic treatment and staging of early ovarian cancer.  J Minimal Inv Gyn. 2008;  15 414-419
• 169 Hopkins M P, Morley G W. The second-look operation and surgical reexploration in ovarian tumor of low malignant potential.  Obstet Gynecol. 1989;  74 375-378
• 170 Darai E, Tulpin L, Prugnolle H et al. Laparoscopic restaging of borderline ovarian tumors.  Surg Endosc. 2007;  21 2039-2043
• 171 Fauvet R, Boccara J, Dufournet C et al. Restaging surgery for women with borderline ovarian tumors.  Cancer. 2004;  100 1145-1151
• 172 Querleu D, Papageorgiou T, Lambaudie E et al. Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours.  BJOG. 2003;  110 201-204
• 173 Gershenson D M. Clinical management potential tumors of low malignancy.  Best Pract Res Clin Obstet Gynecol. 2002;  16/4 513-527
• 174 Kurman R J, Trimble C L. The behavior of serous tumors of low malignant potential: Are they ever malignant?.  Inter J Gynecol Pathol. 1993;  12 120-127
• 175 Suh-Burgmann E. Long-term outcomes following conservative surgery for borderline tumor of the ovary: a large population-based study.  Gynecol Oncol. 2006;  103 841-847
• 176 Poncelet C, Fauvet R, Boccara J et al. Recurrence after cystectomy for borderline ovarian tumors: Results of a French multicenter study.  Ann Surg Oncol. 2006;  13 565-571
• 177 Yinon Y, Beiner M E, Gotlieb W H et al. Clinical outcome of cystectomy compared with unilateral salpingo-oophorectomy as fertility-sparing treatment of borderline tumors.  Fertil Steril. 2007;  88 479-484
• 178 Fauvet R, Poncelet C, Boccara J et al. Fertility after conservative treatment for borderline ovarian tumors: a French multicenter study.  Fertil Steril. 2005;  83 284-290
• 179 Kehoe S, Powell J. Long-term follow-up of women with borderline ovarian tumors.  Int J Gynaecol Obstet. 1996;  53 139-143
• 180 Beiner M E, Gotlieb W H, Davidson B et al. Infertility treatment after conservative management of borderline ovarian tumors.  Cancer. 2001;  92 320-325
• 181 Borgfeldt C, Iosif C, Masbaeck A. Fertility-sparing surgery and outcome in fertile women with ovarian borderline tumors and epithelial invasive ovarian cancer.  Eur J Obstet Gynecol Rep Biol. 2007;  134 110-114
• 182 Salomon L J, Lhomme C, Pautier P et al. Safety of simple cystectomy in patients with unilateral mucinous borderline tumors.  Fertil Steril. 2006;  85 1510.e1-4
• 183 Morice P. Borderline tumours of the ovary and fertility.  Eur J Cancer. 2006;  42 149-158
• 184 du Bois A, Reuss A, Pujade-Lauraine E et al. The role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer. A combined exploratory analysis of three prospectively randomized phase III multicenter trials by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d'Investigateurs Nationaux pour les Etudes des Cancers de l'Ovaire (GINECO).  Cancer. 2009;  115 1234-1244
• 185 Winter III W E, Maywell G L, Tian C et al. Tumor residual after surgical cytoreduction in prediction of clinical outcome in stage IV epithelial ovarian cancer: A Gynecologic Oncology Group study.  J Clin Oncol. 2008;  26 83-89
• 186 Winter III W E, Maxwell G L, Tian C T et al. Prognostic factors for stage III epithelial ovarian cancer: A Gynecologic Oncology Group study.  J Clin Oncol. 2007;  25 3621-3627
• 187 Tinelli R, Tineli A, Tinelli F G et al. Conservative surgery for borderline ovarian tumors: A review.  Gynecol Oncol. 2006;  100 185-191
• 188 Park J-Y, Bae J, Lim M C et al. Laparoscopic and laparotomic staging in stage I epithelial ovarian cancer: a comparison of feasibility and safety.  Int J Gynecol Oncol. 2008;  18 1202-1209
• 189 Obermair A, Hiebl S. Laparoscopy in the treatment of ovarian tumours of low malignant potential.  Aust NZ J Obstet Gynaecol. 2007;  47 438-444
• 190 Zivanovic O, Sonoda Y, Diaz J P et al. The rate of port-site metastases after 2251 laparoscopic procedures in women with underlying malignant disease.  Gynecol Oncol. 2008;  111 431-437
• 191 Ramirez P T, Frumovitz M, Wolf J K et al. Laparoscopic port-site metastases in patients with gynecological malignancies.  Int J Gynecol Cancer. 2004;  14 1070-1077
• 192 Vergote I, Marquette S, Amant F et al. Port-site metastases after open laparoscopy: a study in 173 patients with advanced ovarian carcinoma.  Int J Gynecol Cancer. 2005;  15 776-779
• 193 Huang K-G, Wang C-J, Chang T-C et al. Management of port-site metastasis after laparoscopic surgery for ovarian cancer.  Obstet Gynecol. 2003;  189 16-21
• 194 Morice P, Camatte S, Larregain-Fournier D et al. Port-site implantation after laparoscopic treatment of borderline ovarian tumors.  Obstet Gynecol. 2004;  104 1167-1170
• 195 Havrilesky L J, Peterson B L, Dryden D K et al. Predictors of clinical outcomes in the laparoscopic management of adnexal masses.  Obstet Gynecol. 2003;  102 243-251
• 196 Sainz de la Cuesta R S, Goff B A, Fuller A F et al. Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms.  Obstet Gynecol. 1994;  84 1-7
• 197 Vergote I, De Brabanter J, Fyles A et al. Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma.  Lancet. 2001;  375 176-182
• 198 Medeiros L R, Stein A T, Fachel J et al. Laparoscopy versus laparotomy for benign ovarian tumor: a systematic review and metaanalysis.  Int J Gynecol Cancer. 2008;  18 387-399
• 199 Brown Jones M. Borderline ovarian tumors: Current concepts for prognostic factors and clinical management.  Clin Obstet Gynecol. 2006;  49 517-525
• 200 Barnhill D, Heller P, Brzozowski P et al. Epithelial ovarian carcinoma of low malignant potential.  Obstet Gynecol. 1985;  65 53-59
• 201 Swanton A, Bankhead C R, Kehoe S. Pregnancy rates after conservative treatment for borderline ovarian tumours: A systematic review.  Eur J Obstet Gynecol. 2007;  135 3-7
• 202 Attar E, Berkman S, Topuz S et al. Evolutive peritoneal disease after conservative management and the use of infertility drugs in a patient with stage IIIC borderline micro-papillary serous carcinoma (MPSC) of the ovary: Case report.  Human Reproduction. 2004;  19 1472-1475
• 203 Hoffman J S, Laird L, Benadiva C et al. Case Report: In vitro fertilization following conservative management of stage 3 serous borderline tumor of the ovary.  Gynecol Oncol. 1999;  74 515-518
• 204 Mantzavinos T, Kanakas N, Genatas C et al. Five years' follow-up in the two patients with borderline tumours of the ovary hyperstimulated by gonadotrophin therapy for in-vitro fertilization.  Human Reproduction. 1994;  9 2032-2033
• 205 Jeruss J S, Woodruff T K. Preservation of fertility in patients with cancer.  N Engl J Med. 2009;  360 902-911
• 206 Fain-Kahn V, Poirot C, Uzan C et al. Feasibility of ovarian cryopreservation in borderline ovarian tumours.  Hum Reprod. 2009;  1 1-6
• 207 Crispens M A. Borderline ovarian tumours: a review of the recent literature.  Cur Opin Obstet Gynecol. 2003;  15 39-48
• 208 Ortiz B H, Ailawadi M, Colitti C et al. Second primary or recurrence? Comparative patterns of p 53 and K-ras mutations suggest that serous borderline ovarian tumors and subsequent serous carcinomas are unrelated tumors.  Cancer Res. 2001;  61 7264-7267
• 209 Emerson R E, Wang M, Liu F et al. Molecular genetic evidence of an independent origin of serous low malignant potential implants and lymph node inclusions.  Int J Gynecol Pathol. 2007;  26 387-394
• 210 Gu J, Roth L M, Younger C et al. Molecular evidence for the independent origin of extra-ovarian papillary serous tumors of low malignant potential.  J Natl Cancer Inst. 2001;  93 1147-1152
• 211 Bouchardy C, Fernandez S, Merglen A et al. Increased risk of second cancer among patients with ovarian borderline tumors.  Gynecol Oncol. 2008;  109 210-214
• 212 Crispens M A, Bodurka D, Deavers M et al. Response and survival in patients with progressive or recurrent serous tumors of low malignant potential.  Obstet Gynecol. 2002;  99 3-10
• 213 Genadry R, Poliakoff S, Rotmensch J et al. Primary, papillary peritoneal neoplasia.  Obstet Gynecol. 1981;  58 730-734
• 214 Russel P, Merkur H. Proliferating ovarian “epithelial” tumours: A clinico-pathological analysis of 144 cases.  Aust N Z J Obstet Gynaec. 1979;  19 45-51
• 215 Schmeler K M, Gershenson D M. Low-grade serous ovarian cancer: a unique disease.  Curr Oncol Rep. 2008;  10 519-523