Clinical outcome and risk factors for recurrence in borderline ovarian tumours

We investigated the long-term prognosis of borderline ovarian tumours and determined risk factors for recurrence. One hundred and twenty-one borderline ovarian tumours treated between 1994 and 2003 at the participating institutions in the Tohoku Gynecologic Cancer Unit were retrospectively investigated for clinical stage, histopathological subtype, surgical technique, postoperative chemotherapy, the presence or absence of recurrence, and prognosis. The median follow-up period was 57 months (1–126 months). One hundred and nine cases (90.6%) were at clinical stage I. The histopathological subtypes consisted of 91 cases of mucinous tumour (75.2%), 27 cases of serous tumour (22.3%), and three cases of endometrioid tumour. Conservative surgery was used in 53 cases (43.8%), radical surgery in 68 cases (56.2%), a staging laparotomy in 43 cases (35.5%), and postoperative adjuvant therapy in 30 cases (24.8%). Recurrence was found in eight cases, but no tumour-related deaths were reported. Although no significant difference in disease-free survival rate was seen between different clinical stages, the difference in disease-free survival rate between serous and nonserous (mucinous and endometrioid) types was significant (P<0.05). The 10-year disease-free survival rate was 89.1% for the radical surgery group and 57.4% for the conservative surgery group – this difference was significant (P<0.05). In the conservative surgery group, cystectomy and serous tumour were independent risk factors for recurrence. Although recurrence was observed, the long-term prognosis of borderline ovarian tumour was favourable, without tumour-related deaths. Considering the favourable prognosis, conservative surgery can be chosen as far as the patient has a nonserous tumour and receive adnexectomy. However, in cases of serous type and/or receiving cystectomy special care should be given as relative risk rates of recurrence elevate by 2–4-folds

Seminaire de techniques de chirurgie gynecologique carcinologique : cancer du col uterin, cancer de l'ovaire, cancer du corps uterin, cancer de la vulve, chirurgie conventionnelle et coelioscopique Villejuif, 12-14 septembre 2002

Available from INIST (FR), Document Supply Service, under shelf-number : Y 34074 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueSIGLEInstitut Gustave Roussy (IGR), 94 - Villejuif (France). Dept. de Chirurgie Generale CarcinologiqueFRFranc

Seminaire de techniques de chirurgie gynecologique carcinologique :cancer du col uterin, cancer de l'ovaire, cancer du corps uterin, cancer de la vulve Villejuif, septembre 2001

SIGLEAvailable from INIST (FR), Document Supply Service, under shelf-number : Y 33571 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueInstitut Gustave Roussy (IGR), 94 - Villejuif (France). Dept. de Chirurgie Generale CarcinologiqueFRFranc

[Laparoscopic treatment of borderline ovarian tumor: analysis of 54 patients and clinical outcomes]

International audienceOBJECTIVE: The aim of this study is to assess the clinical outcomes of laparoscopic treatment of borderline ovarian tumor (BOT). PATIENTS AND METHODS: Retrospective analysis of 54 patients treated using a laparoscopic approach for a BOT between January 1984 and January 2002. RESULTS: A conservative management was initially performed in 45 patients (83%). Twenty-six patients underwent a reassessment surgery and 7 (27%) of them were upstaged following this procedure. Seven (13%) patients recurred in a remaining ovary following conservative surgery (5 patients) or on the peritoneum (2 patients). Three port-site localizations were observed. None of the patients treated with conservative management had recurrent disease under the form of ovarian carcinoma. Nine spontaneous pregnancies were observed in 6 patients from a group of 19 patients desiring pregnancy. All patients are today alive and disease-free. DISCUSSION AND CONCLUSION: Our study suggests that laparoscopic treatment could be safely performed in young patients with early stage BOT. Such procedure should be further evaluated in patients with BOT and peritoneal implants

Laparoscopy in the treatment of ovarian tumours of low malignant potential

Laparoscopy is increasingly used by gynaecologists for the investigation of adnexal masses. Uncertainty exists whether ovarian tumours of low malignant potential can effectively be treated by laparoscopy, whether staging bears a benefit for all patients, whether port-site metastases are a problem and how long patients need to be followed up after surgery. This review summarises the evidence to address these important questions