Ovarian tumors of borderline malignancy: a review of 247 patients from 1991 to 2004
| Autor: | Tew Hong Ho, Y. Chua, J. J.H. Low, H. F. Wong, E. H. Tay, I. Busmanis |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent medicine.medical_treatment media_common.quotation_subject Fertility Recurrence medicine Carcinoma Frozen Sections Humans Stage IIIC Neoplasms Glandular and Epithelial Stage (cooking) media_common Aged Neoplasm Staging Retrospective Studies Aged 80 and over Ovarian Neoplasms Chemotherapy Hysterectomy business.industry Obstetrics and Gynecology Middle Aged medicine.disease Surgery Serous fluid Oncology Female business Clear cell |
| Zdroj: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 17(2) |
| ISSN: | 1048-891X |
| Popis: | Borderline ovarian tumors account for 15% of epithelial ovarian cancers and are different from invasive malignant carcinoma. Majority are early stage, occurring in women in the reproductive age group, where fertility is important. We reviewed retrospectively 247 such cases treated at the Gynaecological-Oncology Unit, KK Women's and Children's Hospital, between January 1991 and December 2004. The mean age was 38 years (16–89 years). Majority of the cases (92%) were FIGO stage I (Ia, 75%; Ib, 1%; and Ic, 16%). Seven (3.5%) patients were diagnosed as having stage II disease, six (2.5%) as stage IIIa, two (1%) as stage IIIb, and four (2%) as stage IIIc. Histological origin was as follows: mucinous (68%), serous (26%), endometrioid (2.6%), and clear cell (1.2%). Primary surgical procedures undertaken were as follows: hysterectomy with bilateral salpingo-oophorectomy (52%), unilateral salpingo-oophorectomy (33%), or ovarian cystectomy (15%). Adjuvant chemotherapy was administered in 13 patients (5.2% of cases), of which 4 patients were given chemotherapy only because of synchronous malignancies. There were six recurrences (2.4% of cases). Overall mean time to recurrence was 59 months. Recurrence rate for patients who underwent a primary pelvic clearance was 1.6% compared to fertility-sparing conservative surgery (3.3%; although P= 0.683). No significant difference was noted in recurrence and mortality between staged versus unstaged procedures. The overall survival rate was 98.0%. There were a total of five deaths (2.8%): three (1.5%) from invasive ovarian/peritoneal carcinoma and two from synchronous uterine malignancies. It appears that surgical resection is the mainstay of treatment, with conservative surgery where fertility is desired or pelvic clearance if the family is complete. Surgical staging is important to identify invasive extraovarian implants that portend an adverse prognosis. The role of adjuvant chemotherapy is not established. |
| Databáze: | OpenAIRE |
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