Management of borderline ovarian tumors: A tertiary referral center experience in Egypt

Abstract

BackgroundIn this retrospective study, we discuss our experience as a large tertiary referral center in Egypt in the management and follow-up of borderline tumorsPatients and methodsThis is a retrospective cohort study where all patients diagnosed with a borderline ovarian tumor at Oncology Center Mansoura University from November 2014 to June 2020 were included. Demographics, preoperative, operative, postoperative, pathologic, and oncologic follow-up data were retrieved from a prospectively maintained electronic database. The included patients were followed until April 2022.ResultsWe included 27 patients with borderline ovarian tumors. The mean age of the study patients was 47.67 ± 16.39 years. The median CA 125 was 33 (6–304 U/ml). Frozen section examination was utilized in 13 patients (48.14%), where a diagnosis of borderline ovarian tumors was revealed in 8 patients. Recurrence was reported in one patient with serous type after approximately 26 months. The most common pathological type in our cohort was the mucinous borderline type reported in 14 patients (51.9%), followed by the serous type reported in 11 patients (40.7%), and the seromucinous type in 1 patient only. Patients with mucinous borderline type were significantly younger (40.083 ± 18.47 vs. 53.73 ± 11.91 years, p = 0.028). Interestingly, Cancer Antigen 125 levels were significantly higher in mucinous than serous and seromucinous types [67(16–304) vs. 20(6–294.6) U/ml, p = 0.027]. On the other hand, the radiological tumor size of serous and seromucinous types was larger than that of the mucinous type [23(19–31) cm vs. 8(5–20) cm, p = 0.001]. Over a median follow-up period of 58.66 (54.16–63.16) months, only one postoperative mortality was reported, while only one recurrence was reported.ConclusionBorderline ovarian tumors still represent a dilemma either in diagnosis or management. A frozen section examination could help to reach a preliminary diagnosis. Total abdominal hysterectomy and bilateral salpingo-oophorectomy are the cornerstone of surgical management; however, fertility-sparing surgery could be a valid option for women desiring fertility.

Borderline Ovarian Tumors: Recurrence Patterns and Management

“…Hence, results concerning fertility have been reported revealing a pregnancy rate between 32% and 63% after fertility-sparing surgery (FSS) [8][9][10]. However, comprehensive surgery and surgical staging remain the standard treatment in case of extended disease and older age [11].Management may vary between centers or clinicians [12]. For that reason, we aimed to evaluate possible risk factors for disease recurrence, recurrence patterns and obstetric outcomes after FSS in BOTs and share the experience of a single institution with a standard approach over 13 years.…”

Retrospective study of characteristics and hyperthermia intraperitoneal perfusion in mucinous borderline ovarian tumor and mucinous ovarian carcinoma

“…Primary MOC accounts for 3-10% of all epithelial ovarian cancer (5). MOC usually presents as a huge pelvic mass which can be symptomatic or asymptomatic at diagnosis (2), There are concerns regarding the risk of intraoperative cyst rupture, whereby mucus enters the abdominal and pelvic cavity, which can induce peritoneal hyperplasia and metaplasia into mucusproducing epithelium, forming peritoneal myxoma, which accounts for 2-5% of ovarian mucinous tumors; the 5-year survival rate is about 45-54%, and the 10-year survival rate is about 18% (6).…”

“…Primary MOC accounts for 3–10% of all epithelial ovarian cancer ( 5 ). MOC usually presents as a huge pelvic mass which can be symptomatic or asymptomatic at diagnosis ( 2 ).…”