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Gynecol Oncol. 2014 Jan;132(1):23-7. doi: 10.1016/j.ygyno.2013.11.006. Epub 2013 Nov 9.

Adjuvant platinum-based chemotherapy for borderline serous ovarian tumors with invasive implants.

Author information

1
Department of Medicine, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France. Electronic address: Alexandra.leary@igr.fr.
2
Department of Medicine, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
3
Department of Pathology, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
4
Department of Surgery, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.

Abstract

BACKGROUND:

Most borderline ovarian tumors (BOTs) are cured with surgery. However BOTs with invasive implants have a poor prognosis with a mortality of 20-40%. The benefit of adjuvant chemotherapy (CT) in this setting remains poorly defined.

METHODS:

Retrospective study of serous BOT+invasive implants treated with adjuvant CT.

RESULTS:

36 patients were referred with serous BOTs+invasive implants and treated with surgery and platinum-based CT between 06/1982 and 02/2011. 83% were stage III/IV. Tumors demonstrated microinvasion, micropapillary pattern or desmoplastic implants in 53%, 47% and 67% of cases, respectively. 8% had fertility-sparing surgery. Taking into account initial and completion surgeries, R0 was achieved in 84% (27/32) (NA, N=4). The majority (72%) received a combination of platinum+taxane. 11% of patients experienced a G3/G4 toxicity. 13 of 36 (36%) patients relapsed at a median of 27.3 months after diagnosis of invasive implants. Among 12 patients with histologically confirmed relapse, 8 patients progressed with invasive disease in the form of carcinoma or invasive implants. 5 year PFS/OS were 67%/96%. Neither microinvasion, micropapillary pattern, nor desmoplastic implants predicted relapse. In cases with evaluable disease, an objective response to chemotherapy was observed in 4 of 6 patients.

CONCLUSION:

This is the largest study of BOT with invasive implants treated with surgery and adjuvant platinum-based CT. Treatment was well tolerated and the invasive relapse rate was 22% (8/36). Although numbers are small, the objective responses suggest a possible role for adjuvant CT in BOTs with invasive implants.

KEYWORDS:

Adjuvant chemotherapy; Invasive implants; Serous borderline ovarian tumor

PMID:
24219980
DOI:
10.1016/j.ygyno.2013.11.006
[Indexed for MEDLINE]

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