Borderline ovarian tumours : An update

C Priya; Sunesh Kumar; Lalit Kumar

doi:10.4103/0971-5851.51427

Indian Journal of Medical and Paediatric Oncology, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2008; 29(02): 19-27
DOI: 10.4103/0971-5851.51427

Review Article

Borderline ovarian tumours : An update

C Priya

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi-110029, India

,

Sunesh Kumar

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi-110029, India

,

Lalit Kumar

Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi-110029, India

› Institutsangaben

Abstract

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Abstract

Borderline ovarian tumours are clinical entities less frequently encountered by obstetricians and gynecologists. Management options keep on changing with time and fertility sparing procedures and laparoscopy keep emerging. Surgical removal of all visible tumours still remains the most effective management. So far, non surgical treatment modalities have not been found to be beneficial. Pathologists are increasingly able to identify poor prognostic features in histology. Molecular biological studies are progressively being elucidated as prognostic features which might help us more in understanding the carcinogenic process and progression of the disease. This review outlines the recent literature regarding pathology, diagnosis, treatment, prognosis and recurrence. Oncologic concerns are discussed with emphasis on mode of surgery, fertility sparing surgery and the outcomes.

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Referenzen

References
1 Taylor HC. Malignant and semi-malignant tumours of the ovary. Surg Gynecol Obstet 1929;48:204-30.
2 Barakat RR. Borderline tumours of the ovary. Obstet Gynecol Clin North Am 1994;21:93-105.
3 Kennedy AW, Hart WR. Ovarian papillary serous tumours of low malignant potential (serous borderline tumours): a long term follow-up study, including patients with microinvasion, lymph node metastasis, and transformation to invasive serous carcinoma. Cancer 1996;78:278-286.
4 Trope′ C, Kaern J. Management of borderline tumours of the ovary: state of the art. Semin Oncol 1998;25:372-80.
5 Riman T, Dickman PW, Nilsson S, Correia N, Nordlinder H, Magnusson PM et al. Risk factors for epithelial borderline ovarian tumours: results of a Swedish case-control study. Gynecol Oncol 2001;83:575- 85.
6 Werness BA, Ramus SJ, DiCioccio RA, Whittemore AS, Garlinghouse-Jones K, Oakley-Girvan I, et al. Histopathology, FIGO stage, and BRCA mutation status of ovarian cancers from the Gilda Radner Familial Ovarian Cancer Registry. Int J Gynecol Pathol 2004; 23:29 - 34.
7 Gotlieb WH, Chetrit A, Menczer J, Hirsh-Yechezkel G, Lubin F, Friedman E et al. Demographic and genetic characteristics of patients with borderline ovarian tumours as compared to early stage invasive ovarian cancer. Gynecol Oncol 2005; 97:780-783
8 Link Jr CJ, Reed E, Sarosy G, Kohn E. Borderline ovarian tumours. Am J Med 1996; 101:217-25.
9 Salomon LJ, Lhommι C, Pautier P, Duvillard P and Morice P. Safety of simple cystectomy in patients with unilateral mucinous borderline tumours. Fertil Steril 2006; 85:1510.e1-4.
10 Tinelli R, Tinelli A, Tinelli FG, Cicinelli E and Malvasi A. Conservative surgery for borderline ovarian tumours: a review. Gynecol Oncol 2006; 100:185-191.
11 Dietel M, Hauptmann S. Serous tumours of low malignant potential of the ovary. Virchows Arch 2000; 436:403-412.
12 Seidman J D, Kurman R J. Subclassification of serous borderline tumours of the ovary into benign and malignant types: a clinicopathologic study of 65 advanced stage cases. Am J Surg Pathol 1996; 20:1331- 1345.
13 Seidman JD, Ronnett BM, Kurman RJ. Evolution of the concept and terminology of borderline ovarian tumours. Current Diagnostic Pathology 2000; 6:31-37
14 Eichorn J H, Bell D A, Young R H, Scully R E. Ovarian serous borderline tumours with micropapillary and cribriform patterns: a study of 40 cases and comparison with 44 cases without these patterns. Am J Surg Pathol 1999; 23:397-409.
15 McKenney JK, Balzer BL, Longacre TA. Patterns of stromal invasion in ovarian serous tumours of low malignant potential (borderline tumours): a reevaluation of the concept of stromal microinvasion. Am J Surg Pathol 2006;30(10):1209-21.
16 Malpica A, Deavers MT, Gershenson D, Tortolero-Luna G, Silva EG. Serous tumours involving extraabdominal/ extra-pelvic sites after the diagnosis of an ovarian serous neoplasm of low malignant potential. Am J Surg Pathol 2001;25(8): 988-996.
17 Tan LK, Flynn SD, Carcangiu ML. Ovarian serous borderline tumours with lymph node involvement. Am J Surg Pathol 1994;18:904-912. .
18 Rota SM, Zanetta G, Ieda N, et al. Clinical relevance of retroperitoneal involvement from epithelial ovarian tumours of borderline malignancy. Int J Gynecol Cancer 1999;9:477-480.
19 Hart WR. Borderline epithelial tumours of the ovary. Mod Path 2005;18(2):S33-50.
20 Ronnett BM, Kurman RJ, Zahn CM, Shmookler BM, Jablonski KA, Kass ME et al. Pseudomyxoma peritonei in women: a clinicopathologic analysis of 30 cases with emphasis on site of origin, prognosis, and relationship to ovarian mucinous tumours of low malignant potential. Hum Pathol 1995;26:509-524.
21 Misdraji J, Yantiss RK, Graeme-Cook FM, Balis UJ, Young RH. Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases. Am J Surg Pathol 2003;27:1089-1103.
22 Vine MF, Calingaert B, Berchuck A, Schildkraut JM. Characterization of prediagnostic symptoms among primary epithelial ovarian cancer cases and controls. Gynecol Oncol 2003;90:75-82
23 Paulsen T, Kaern J, Kjaerheim K, Tropι C, Tretli S. Symptoms and referral of women with epithelial ovarian tumours. Int J Gynaecol Obstet. 2005;88(1):31-7.
24 Goff BA, Mandel L, Muntz HG, Melancon CH. Ovarian carcinoma diagnosis. Cancer 2000;89:2068-75.
25 Vine MF, Ness RB, Calingaert B, Schildkraut JM, Berchuck A. Types and duration of symptoms prior to diagnosis of invasive or borderline ovarian tumour. Gynecol Oncol 2001;83:466-71.
26 Emoto M, Udo T, Obama H, Eguchi F, Hachisuga T, Kawarabayashi T. The blood flow characteristics in borderline ovarian tumours based on both color Doppler ultrasound and histopathological analyses. Gynecol Oncol. 1998;70(3):351-7
27 Exacoustos C, Romanini ME, Rinaldo D, Amoroso C, Szabolcs B, Zupi E, Arduini D. Preoperative sonographic features of borderline ovarian tumours. Ultrasound Obstet Gynecol. 2005;25(1):50-9
28 Schutter EM, Kenemans P, Sohn C, Kristen P, Crombach G, Westermann R, et al. Diagnostic value of pelvic examination, ultrasound, and serum CA 125 in postmenopausal women with a pelvic mass. An international multicenter study. Cancer 1994;74:1398- 406.
29 Zanetta G, Lissoni A, Cha S, Bertalero C, Scalambrino S, Bratina G. Pre-operative morphological and colour Doppler features of borderline ovarian tumours. Br J Obstet Gynaecol 1995;102:990-6.
30 Gotlieb WH, Soriano D, Achiron R, Zalel Y, Davidson B, Kopolovic J et al. CA 125 measurement and ultrasonography in borderline tumours of the ovary. Am J Obstet Gynecol 2000;183(3):541-6.
31 Engelen MJ, de Bruijn HW, Hollema H, ten Hoor KA, Willemse PH, Aalders JG et al. Serum CA 125, carcinoembryonic antigen, and CA 19-9 as tumour markers in borderline ovarian tumours. Gynecol Oncol. 2000;78:16-20.
32 Tamakoshi K, Kikkawa F, Shibata K, Tomoda K, Obata HN, Wakahara F, et al. Clinical value of CA125, CA19-9, CEA, CA72-4, and TPA in borderline ovarian tumour. Gynecol Oncol 1996;62:67-72.
33 Scully RE, Young RH, Clement PB. Tumours of the ovary, maldeveloped gonads, fallopian tube, and broad ligament. In: Rosai J (ed). Atlas of Tumour Pathology, Third Series, Fascicle 23. Armed Forces Institute of Pathology: Washington, DC, 1998.
34 Gershenson DM. Contemporary treatment of borderline ovarian tumours. Cancer Invest. 1999;17:206-210.
35 Camatte S, Morice P, Atallah D, Pautier P, Lhomme C, Haie-Meder C, et al. Lymph node disorders and prognostic value of nodal involvement in patients treated for a borderline ovarian tumour: an analysis of a series of 42 lymphadenectomies. J Am Coll Surg 2002;195:332- 8.
36 Camatte S, Morice P, Thoury A, Fourchotte V, Pautier P, Lhomme C 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
37 Desfeux P, Camatte S, Chatellier G, Blanc B, Querleu D and Lecuru F. Impact of surgical approach on the management of macroscopic early ovarian borderline tumours. Gynecol Oncol 2005;98:390-395.
38 Winter III WE, Kucera PR, Rodgers W, McBroom JW, Olsen C, Maxwell GL. Surgical staging in patients with ovarian tumours of low malignant potential. Obstet Gynecol 2002;100(4):671-6.
39 Fauvet R, Boccara J, Dufournet C, David-Montefiore E, Poncelet C, Darai E. Restaging surgery for women with borderline ovarian tumours: results of a French multicenter study. Cancer 2004; 100(6):1145-51.
40 Querleu D, Papageorgiou T, Lambaudie E, Sonoda Y, Narducci F and LeBlanc E. Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours. BJOG 2003;110,201-204.
41 Morice P, Camatte S, Rey A, Atallah D, Lhomme C, Pautier P et al. Prognostic factors of patients with advanced stage serous borderline tumour of the ovary. Ann Oncol 2003;14:592- 8.
42 Trope C, Kaern J, Vergote IB, Kristensen G, Abeler V. Are borderline tumours of the ovary over treated both surgically and systemically? A review of four prospective randomized trials including 253 patients with borderline tumours. Gynecol Oncol 1993;51:236- 243.
43 Barakat RR, Benjamin I, Lewis JL Jr, Saigo PE, Curtin JP, Hoskins WJ. Platinum-based chemotherapy for advanced-stage serous ovarian carcinoma of low malignant potential. Gynecol Oncol. 1995;59:390-393.
44 Fort MG, Pierce VK, Saigo PE, Hoskins WJ, Lewis JL Jr. Evidence for the efficacy of adjuvant therapy in epithelial ovarian tumours of low malignant potential. Gynecol Oncol. 1989;32(3):269-72
45 Gershenson D, Silva E, Levy L, Burke TW, Wolf JK, Tornos C. Ovarian serous borderline tumours with invasive peritoneal implants. Cancer 1998; 82:1096-103.
46 Crispens MA, Bodurka D, Deavers M, Lu K, Silva EG, Gershenson DM. Response and survival in patients with progressive or recurrent serous ovarian tumours of low malignant potential. Obstet Gynecol 2002;99:3- 10.
47 Morice P, Camatte S, Wicart-Poque F, Atallah D, Rouzier R, Pautier P, Pomel C, Lhomme C, Duvillard P and Castaigne D. Results of conservative management of epithelial malignant and borderline ovarian tumours. Hum Reprod Update 2003;9:185-112.
48 Poncelet C, Fauvet R, Boccara J, Darai͸E. Recurrence after Cystectomy for Borderline Ovarian Tumours: Results of a French Multicenter Study. Annals Surg Oncology 2006;13(4):565)571
49 Palomba S, Zupi E, Russo T, Falbo A, Negro SD, Manguso F, Marconi D, Tolino A, Zullo F. Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: a randomized controlled study. Human Reproduction 2007;22:578-585
50 Boran N, Cil AP, Tulunay G, Ozturkoglu E, Koc S, Bulbul D and Kose MF. Fertility and recurrence results of conservative surgery for borderline ovarian tumours. Gynecol Oncol 2005;97:845-851.
51 Fauvet R, Poncelet C, Boccara J, Descamps P, Fondrinier E and Darai E. Fertility after conservative management for borderline ovarian tumours: a French multicenter study. Fertil Steril 2005;83:284-290.
52 Romagnolo C, Gadducci A, Sartori E, Zola P and Maggino T. Management of borderline ovarian tumours: Results of an Italian multicenter study. Gynecol Oncol 2006;101(2):255-260.
53 Zanetta G, Rota S, Chiari S, Bonazzi C, Bratina G, Mangioni C. Behavior of borderline tumours with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol 2001;19:2656-64.
54 Camatte S, Morice P, Pautier P, Atallah D, Lhomme΄ C, Duvillard P, et al. Fertility results after conservative treatment of advanced stage serous borderline tumours of the ovary. BJOG 2002;109:373- 80.
55 Deffieux X, Morice P, Camatte S, Fourchotte V, Duvillard P and Castaigne D. Results after laparoscopic management of serous borderline tumour of the ovary with peritoneal implants. Gynecol Oncol 2005;97:84-89.
56 Darai E, Teboul J, Fauconnier A, Scoazec JY, Benifla JL, Madelenat P. Management and outcome of borderline ovarian tumours incidentally discovered at or after laparoscopy. Acta Obstet Gynecol Scand 1999;77:451- 7.
57 Candiani M, Vasile C, Sgherzi MR, Nozza A, Maggi F, Maggi R. Borderline ovarian tumours: laparoscopic treatment. Clin Exp Obstet Gynecol 1999;26:39- 43.
58 Seracchioli R, Venturoli S, Colombo FM, Govoni F, Missiroli S, Bagnoli A. Fertility and tumour recurrence rate after conservative laparoscopic management of young women with early-stage borderline ovarian tumours. Fertil Steril 2001;76:999- 1004.
59 Camatte S, Morice P, Atallah D, Thoury A, Pautier P, Lhomme C et al. Clinical outcome after laparoscopic pure management of borderline ovarian tumours: results of a series of 34 patients. Ann Oncol 2004;15:605- 9.
60 Donnez J, Munschke A, Berliere M, Pirard C, Jadoul P, Smets M, et al. Safety of conservative management and fertility outcome in women with borderline tumours of the ovary. Fertil Steril 2003;79:1216- 21.
61 Gotlieb WH, Flikker S, Davidson B, Korach Y, Koppolovic J, Benbaruch G. Borderline tumours of the ovary: fertility treatment, conservative management, and pregnancy outcome. Cancer 1998;82:141- 6.
62 Fortin A, Morice P, Thoury A, Camatte S, Dhainaut C, Madelenat P. Impact of infertility drugs after treatment of borderline ovarian tumours: results of a retrospective multicenter study. Fertil Steril. 2007;87(3):591-6.
63 Zanetta G, Rota S, Lissoni A. Ultrasound, physical examination, and CA125 measurement for the detection of recurrence after conservative surgery for early borderline ovarian tumours. Gynecol Oncol 2001;81:63- 6.
64 Geomini P, Bremer G, Kruitwagen R, Mol BWJ. Diagnostic accuracy of frozen section diagnosis of the adnexal mass: a meta analysis. Gynecol Oncol 2005;96:1-9.
65 Rose PG, Rubin RB, Nelson BE, Hunter RE, Reale FR. Accuracy of frozen-section (intraoperative consultation) diagnosis of ovarian tumours. Am J Obstet Gynecol 1994;171(3):823-6.
66 Tempfer CB, Polterauer S, Bentz EK, Reinthaller A, Hefler LA. Accuracy of intraoperative frozen section analysis in borderline tumours of the ovary: a retrospective analysis of 96 cases and review of the literature Gynecol Oncol. 2007;107(2):248-52.
67 Menzin AW, Rubin SC, Noumoff JS, LiVolsi VA. The accuracy of a frozen section diagnosis of borderline ovarian malignancy. Gynecol Oncol 1995;59:183-5.
68 Houck K, Nikrui N, Duska L, Chang Y, Fuller AF, Bell D. Borderline tumours of the ovary: correlation of frozen and permanent histopathologic diagnosis. Obstet Gynecol 2000;95:839-43.
69 Longacre TA, McKenney JK, Tazelaar HD, Kempson RL, Hendrickson MR. Ovarian serous tumours of low malignant potential (borderline tumours): outcomebased study of 276 patientswith long-term(N or =5- year) follow-up. Am J Surg Pathol 2005; 29(6):707-23.
70 Lee KR, Castrillon DH, Nucci MR. Pathologic findings in eight cases of ovarian serous borderline tumours, three with foci of serous carcinoma, that preceded death or morbidity from invasive carcinoma. Int J Gynecol Pathol 2001; 20:329-334.
71 Seidman JD, Kurman RJ. Ovarian serous borderline tumours: a critical review of the literature with emphasis on prognostic indicators. Hum Pathol. 2000; 31(5):539-57
72 Prat J, de Nictolis M. Serous borderline tumours of the ovary: a long-term follow-up study of 137 cases, including 18 with a micropapillary pattern and 20 with microinvasion. Am J Surg Pathol 2002;26:1111-1128.
73 Hart W R, Norris H J. Borderline and malignant mucinous tumours of the ovary: histologic criteria and clinical behaviour. Cancer 1973; 31:1031-1045.
74 Russell P, Merkur. Proliferating ovarian epithelial tumours: a clinicopathological analysis of 144 cases. Austr NZ J Obstet Gynaecol 1979;19:45-51
75 Riopel M A, Ronnett B M, Kurman R J. Evaluation of diagnostic criteria and behaviour of ovarian intestinal-type mucinous tumours: atypical proliferative (borderline) tumours and intraepithelial, microinvasive, invasive and metastatic carcinomas. Am J Surg Pathol 1999;23:617-635.
76 Silva EG, Tornos C, Zhuang Z, Merino MJ, Gershenson DM. Tumour recurrence in stage I ovarian serous neoplasms of low malignant potential. Int J Gynecol Pathol 1998;17:1-6.
77 Kurman RJ, Trimble CL. The behavior of serous tumours of low malignant potential: are they ever malignant? Int J Gynecol Pathol 1993;12(2):120-7.
78 Cadron I, Leunen K, Van Gorp T, Amant F, Neven P, Vergote I. Management of borderline ovarian neoplasms. J Clin Oncol. 2007;25(20):2928-37
79 Gershenson D, Silva E, Tortolero-Luna G, Levenback C, Morris M, Tornos C. Serous borderline tumours of the ovary with noninvasive peritoneal implants. Cancer 1998; 83:2153- 7.
80 Gershenson DM, Silva EG, Levy L, Burke TW, Wolf JK, Tornos C. Ovarian serous borderline tumours with invasive peritoneal implants. Cancer 1998;82:1096- 1103.
81 Lackman F, Carey MS, Kirk ME, McLachlin CM, Elit L. Surgery as sole treatment for serous borderline tumours of the ovary with noninvasive implants. Gynecol Oncol 2003;90:407- 12.
82 Trope CG, Kristensen G, Makar A. Surgery for borderline tumour of the ovary. Semin Surg Oncol. 2000;19:69-75.
83 Shih IeM and Kurman RJ. Molecular Pathogenesis of Ovarian Borderline Tumours: New Insights and Old Challenges. Clin Cancer Res. 2005;11(20):7273-9.
84 Harlow BL, Fuhr JE, McDonald TW, Schwartz SM, Beuerlein FJ, Weiss NS. Flow cytometry as a prognostic indicator in women with borderline epithelial ovarian tumours. Gynecol Oncol 1993;50:305- 9.
85 Kaern J, Trope CG, Kristensen GB, Abeler VM, Pettersen EO. DNA ploidy; the most important prognostic factor in patients with borderline tumours of the ovary. Int J Gynecol Cancer 1993;3:349-358.