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Ann Oncol. 2014 Jul;25(7):1312-9. doi: 10.1093/annonc/mdu139. Epub 2014 Apr 8.

Influence of histological subtypes on the risk of an invasive recurrence in a large series of stage I borderline ovarian tumor including 191 conservative treatments.

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Department of Gynecologic Surgery Unit INSERM U10-30, Villejuif.
Department of Gynecologic Surgery.
Department of Biostatistics, Institut Gustave Roussy, Villejuif.
Department of Obstetrics and Gynaecology, Hopital Tenon, Paris INSERM UMRS 938, Paris Universite Pierre et Marie Curie (Paris VI), Paris.
Department of Pathology, Hopital Tenon, Paris.
Department of Pathology, Institut Gustave Roussy, Villejuif.
Department of Gynecologic Surgery Unit INSERM U10-30, Villejuif University Paris Sud, Le Kremlin BicĂȘtre, France



The overall prognosis of stage I borderline ovarian tumors (BOT) is excellent but a small percentage of patients die to their disease. The prognostic factors for such a rare event are still not clearly defined. The aim of this study was to determine these factors for recurrence per se and recurrence in the form of invasive carcinoma in a large series of stage I tumors.


A retrospective review of patients with BOT. Three inclusion criteria were defined: (i) a centralized histological review; (ii) macroscopic stage I tumors; (iii) exclusion of metastatic disease to the ovaries.


From 2000 to 2010, 254 patients fulfilled inclusion criteria [140 had mucinous BOT (MBOT) and 114 a serous BOT (SBOT)], and 191 had undergone conservative management. After a median follow-up of 45 months, 43 patients had developed recurrences (31 borderline and 12 invasive). The risks of recurrences were statistically increased after conservative treatment, particularly after a cystectomy, in patients with stage IB and among patients with incompletely staged tumors. In the subgroup of conservatively treated patients (representing 75% of our population), the risks of recurrences were statistically increased in patients affected by a SBOT, in patients who had undergone a cystectomy, in patients with stage IB disease and in patients with a micropapillary pattern (MPP). MBOT and the presence of a MPP were identified as prognostic factors for invasive disease.


In the present series of BOT with the largest number of patients treated conservatively to date, the presence of a MPP and the mucinous subtype were associated with a higher rate of progression to carcinoma after conservative management. These important results suggest that MBOT belong to a 'high-risk' group likely to develop an invasive recurrence after fertility-sparing surgery in stage I BOT.


borderline ovarian tumors; invasive; mucinous; prognostic factors; recurrence; serous

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