The role of restaging borderline ovarian tumors: Single institution experience and review of the literature

Zapardiel, Ignacio; Rosenberg, Piergiorgio; Peiretti, Michele; Zanagnolo, Vanna; Sanguineti, F.; Aletti, Giovanni; Landoni, Fabio; Bocciolone, Luca; Colombo, Nicoletta; Maggioni, Angelo

doi:10.1016/j.ygyno.2010.07.034

Cited by 45 publications

(26 citation statements)

References 19 publications

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“…Retrospective studies demonstrated that there is no difference in recurrence rates between women who undergo restaging of BOTs and those who do not [25][26][27][28]. Restaging procedure does not seem to have a significant impact on the management of patients diagnosed with BOTs, especially in mucinous subtype [28]. Our data are in agreement with those published by Kim et al [29] and suggest that under diagnosis by frozen section examination does not compromise the outcome in patients with BOTs.…”

Section: Discussionsupporting

confidence: 90%

“…No recurrence was observed in the 19 patients with BOTs that were interpreted as benign at frozen section. Retrospective studies demonstrated that there is no difference in recurrence rates between women who undergo restaging of BOTs and those who do not [25][26][27][28]. Restaging procedure does not seem to have a significant impact on the management of patients diagnosed with BOTs, especially in mucinous subtype [28].…”

Section: Discussionmentioning

confidence: 97%

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Accuracy of intra-operative frozen section in the diagnosis of borderline ovarian tumors and clinical impact of underdiagnosis

Ferrero¹,

Morotti²,

Venturini³

et al. 2018

Oncol Res Rev

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Accuracy of intra-operative frozen section in the diagnosis of borderline ovarian tumors and clinical impact of underdiagnosis

Ferrero¹,

Morotti²,

Venturini³

et al. 2018

Oncol Res Rev

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“…In accordance with this fact, a prolonged progressionfree interval was observed if restaging was performed [9]. Nonetheless, the indications for restaging remain controversial, as no differences were observed in terms of overall survival between those who were upstaged and those who were not [61][62][63].…”

Section: Prognostic Parametersmentioning

confidence: 99%

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

et al. 2012

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After completing this course, the reader will be able to:1. Compare the epidemiologic and reproductive risk factors in BOTs with those in ovarian cancers and describe the molecular background of development of BOTs.2. Use the pathological terminology with either original grouping of borderline category or new subclassification of BOTs and assess the major predictor of recurrence and survival.3. Determine an appropriate diagnostic algorithm for patients with symptoms suggesting malignant ovarian tumors that will identify borderline ovarian tumors when present.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBorderline ovarian tumors represent a heterogeneous group of noninvasive tumors of uncertain malignant potential with characteristic histology. They occur in younger women, are present at an early stage, and have a favorable prognosis, but symptomatic recurrence and death may be found as long as 20 years after therapy in some patients. The molecular changes in borderline ovarian tumors indicate linkage of this disease to type I ovarian tumors (lowgrade ovarian carcinomas). The pathological stage of disease and subclassification of extraovarian disease into invasive and noninvasive implants, together with the presence of postoperative macroscopic residual disease, appear to be the major predictor of recurrence and survival. However, it should be emphasized that the most important negative prognostic factor for recurrence is just the use of conservative surgery, but without any impact on patient survival because most recurrent diseases are of the borderline type-easily curable and with an excellent prognosis. Borderline tumors are difficult masses to correctly preoperatively diagnose using imaging methods because their macroscopic features may overlap with invasive and benign ovarian tumors. Over the past several decades, surgical therapy has shifted from a radical approach to more conservative treatment; however, oncologic safety must always be balanced. Follow-up is essential using routine ultrasound imaging, with special attention paid to the remaining ovary in conservatively treated patients. Current literature on this topic leads to a number of controversies that will be discussed thoroughly in this article, with the aim to provide recommendations for the clinical management of these patients. The Oncologist

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“…Although the recurrence rate increases after conservative surgery, compared with standard surgery (10-20% vs. 5%) (20), fortunately a recurrence has a borderline (rather than invasive) histology; therefore survival of patients with conservative surgery does not decrease. The following points should be considered before conservative surgery:…”

Section: Fertility-preserving Conservative Surgerymentioning

confidence: 99%

“…In these cases, making decision to reoperate and restage depends on factors such as the type of histology, abdominal exploration in the previous surgery and probability of the presence of residual tumor (5,(19)(20)(21). When M-BOT is clearly limited to the ovary, it is unlikely that reoperation deteriorates the disease.…”

Section: Role Of Restagingmentioning

confidence: 99%

Diagnosis and Management of Borderline Ovarian Tumor Based on the Iranian Guidelines

Akhavan¹,

Mousavi²,

Alibakhshi³

2016

Obstet Gynecol Cancer Res

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Borderline ovarian tumors (BOT) consist of epithelial ovarian lesions that express cytological features of malignancy, but unlike malignant ovarian tumors, do not show obvious stromal invasion. The tumor incidence is between 1.8 and 4.8 per 100,000 females per year. The two major groups of BOT include serous BOT (S-BOT) and mucinous BOT (M-BOT). S-BOTs are divided into two categories: tumors limited to ovary and tumors spreading outside the ovary. M-BOTs are divided into two categories. The more common type is intestinal that constitutes 85% of cases and the second type is endocervical or Mullerian. Mullerian M-BOTs is bilateral in 40% of cases, while it is accompanied by pelvic endometriosis in 20-30% of patients. Microscopic examination by intraoperative frozen section is necessary because macroscopic view of ovarian tumors alone is not reliable. It is better to perform conservative surgery until the final report is ready in patients who wish to preserve their fertility. It is hard to differentiate them based on clinical characteristics. Values of tumor markers including CA125, CA19-9 and CEA in diagnosis of BOT are confirmed. Standard treatment of BOT is surgery as is the case with invasive epithelial ovarian cancer. In the majority of patients referred for BOT, since there is no suspicion of malignancy, staging is not performed. In these cases, making decision to repeat surgery and staging depend on factors such as the type of histology, abdominal exploration results in the previous surgery and probability of the presence of residual tumor.

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The role of restaging borderline ovarian tumors: Single institution experience and review of the literature

Cited by 45 publications

References 19 publications

Accuracy of intra-operative frozen section in the diagnosis of borderline ovarian tumors and clinical impact of underdiagnosis

Accuracy of intra-operative frozen section in the diagnosis of borderline ovarian tumors and clinical impact of underdiagnosis

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

Diagnosis and Management of Borderline Ovarian Tumor Based on the Iranian Guidelines

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