Status of Surgical Management of Borderline Ovarian Tumors in France: are Recommendations Being Followed? Multicentric French Study by the FRANCOGYN Group.

Carcinoma, Ovarian Epithelial / pathology Cohort Studies Female France / epidemiology Humans Neoplasm Recurrence, Local / epidemiology Neoplasm Staging Ovarian Neoplasms / pathology Retrospective Studies

Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
Nov 2021
Historique:
received: 21 12 2020
accepted: 23 02 2021
pubmed: 28 4 2021
medline: 21 10 2021
entrez: 27 4 2021
Statut: ppublish

Résumé

Borderline ovarian tumors (BOTs) are tumors with a favorable prognosis but whose management by consensus is essential to limit the risk of invasive recurrence. This study aimed to conduct an inventory of surgical practices for BOT in France and to evaluate the conformity of the treatment according to the current French guidelines. This retrospective, multicenter cohort study included nine referral centers of France between January 2001 and December 2018. It analyzed all patients with serous and mucinous BOT who had undergone surgery. A peritoneal staging in accordance with the recommendations was defined by performance of a peritoneal cytology, an omentectomy, and at least one peritoneal biopsy. The study included 332 patients. A laparoscopy was performed in 79.5% of the cases. Treatment was conservative in 31.9% of the cases. The recurrence rate was significantly increased after conservative treatment (17.3% vs 3.1%; p < 0.001). Peritoneal cytology was performed for 95.5%, omentectomy for 83.1%, and at least one biopsy for 82.2% of the patients. The overall recurrence rate was 7.8%, and the recurrence was invasive in 1.2% of the cases. No link was found between the recurrence rate and the conformity of peritoneal staging. The overall rate of staging noncompliance was 22.9%. The current standards for BOT management seem to be well applied.

Sections du résumé

BACKGROUND BACKGROUND
Borderline ovarian tumors (BOTs) are tumors with a favorable prognosis but whose management by consensus is essential to limit the risk of invasive recurrence. This study aimed to conduct an inventory of surgical practices for BOT in France and to evaluate the conformity of the treatment according to the current French guidelines.
METHODS METHODS
This retrospective, multicenter cohort study included nine referral centers of France between January 2001 and December 2018. It analyzed all patients with serous and mucinous BOT who had undergone surgery. A peritoneal staging in accordance with the recommendations was defined by performance of a peritoneal cytology, an omentectomy, and at least one peritoneal biopsy.
RESULTS RESULTS
The study included 332 patients. A laparoscopy was performed in 79.5% of the cases. Treatment was conservative in 31.9% of the cases. The recurrence rate was significantly increased after conservative treatment (17.3% vs 3.1%; p < 0.001). Peritoneal cytology was performed for 95.5%, omentectomy for 83.1%, and at least one biopsy for 82.2% of the patients. The overall recurrence rate was 7.8%, and the recurrence was invasive in 1.2% of the cases. No link was found between the recurrence rate and the conformity of peritoneal staging. The overall rate of staging noncompliance was 22.9%.
CONCLUSION CONCLUSIONS
The current standards for BOT management seem to be well applied.

Identifiants

DOI: 10.1245/s10434-021-09852-9 PMID: 33904003 PMC: PMC8521578
pubmed: 33904003
doi: 10.1245/s10434-021-09852-9
pii: 10.1245/s10434-021-09852-9
pmc: PMC8521578
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

7616-7623

Informations de copyright

© 2021. The Author(s).

Références

Taylors HC. Malignant and semimalignant tumors of the ovary. Surg Gynecol Obstet. 1929;48:204–30.
Hart WR. Borderline epithelial tumors of the ovary. Mod Pathol. 2005;18:33–50. https://doi.org/10.1038/modpathol.3800307 .
doi: 10.1038/modpathol.3800307
Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist. 2012;17:1515–33. https://doi.org/10.1634/theoncologist.2012-0139 .
doi: 10.1634/theoncologist.2012-0139 pubmed: 23024155 pmcid: 3528384
Tropé CG, Kaern J, Davidson B. Borderline ovarian tumours. Best Pract Res Clin Obstet Gynaecol. 2012;26:325–36. https://doi.org/10.1016/j.bpobgyn.2011.12.006 .
doi: 10.1016/j.bpobgyn.2011.12.006 pubmed: 22321906
Sobin LH. The international histological classification of tumours. Bull World Health Organ. 1981;59:813–9.
pubmed: 6978190 pmcid: 2396133
Acs G. Serous and mucinous borderline (low malignant potential) tumors of the ovary. Am J Clin Pathol. 2005. https://doi.org/10.1309/J6PXXK1HQJAEBVPM .
doi: 10.1309/J6PXXK1HQJAEBVPM pubmed: 16100867
Vasconcelos I, Darb-Esfahani S, Sehouli J. Serous and mucinous borderline ovarian tumours: differences in clinical presentation, high-risk histopathological features, and lethal recurrence rates. BJOG Int J Obst Gynaecol. 2016;123:498–508. https://doi.org/10.1111/1471-0528.13840 .
doi: 10.1111/1471-0528.13840
Uzan C, Kane A, Rey A, Gouy S, Duvillard P, Morice P. Outcomes after conservative treatment of advanced-stage serous borderline tumors of the ovary. Ann Oncol. 2009;21:55–60. https://doi.org/10.1093/annonc/mdp267 .
doi: 10.1093/annonc/mdp267 pubmed: 19608617
Bendifallah S, Ballester M, Uzan C, Fauvet R, Morice P, Darai E. Nomogram to predict recurrence in patients with early- and advanced-stage mucinous and serous borderline ovarian tumors. Am J Obstet Gynecol. 2014;211:637.e1-637.e6. https://doi.org/10.1016/j.ajog.2014.06.028 .
doi: 10.1016/j.ajog.2014.06.028
Fauvet R, Poncelet C, Boccara J, Descamps P, Fondrinier E, Daraï E. Fertility after conservative treatment for borderline ovarian tumors: a French multicenter study. Fertil Steril. 2005;83:284–90. https://doi.org/10.1016/j.fertnstert.2004.10.009 .
Uzan C, Muller E, Kane A, et al. Prognostic factors for recurrence after conservative treatment in a series of 119 patients with stage I serous borderline tumors of the ovary. Ann Oncol. 2014;25:166–71. https://doi.org/10.1093/annonc/mdt430 .
doi: 10.1093/annonc/mdt430 pubmed: 24287939
Canlorbe G, Lecointre L, Chauvet P, Azaïs H, Fauvet R, Uzan C. Borderline ovarian tumours: CNGOF guidelines for clinical practice–therapeutic management of early stages. Gynecol Obstet Fertilite Senologie. 2020;48:287–303. https://doi.org/10.1016/j.gofs.2020.01.016 .
doi: 10.1016/j.gofs.2020.01.016
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83. https://doi.org/10.1016/0021-9681(87)90171-8 .
doi: 10.1016/0021-9681(87)90171-8 pubmed: 3558716
Morice P, Uzan C, Fauvet R, Gouy S, Duvillard P, Darai E. Borderline ovarian tumour: pathological diagnostic dilemma and risk factors for invasive or lethal recurrence. Lancet Oncol. 2012. https://doi.org/10.1016/S1470-2045(11)70288-1 .
doi: 10.1016/S1470-2045(11)70288-1 pubmed: 22554549
Observatoire des Tumeurs Malignes Rares Gynécologique. Site des centres experts des TMRGs. Published 2018. Retrieved 16 September 2020 at http://www.ovaire-rare.org/TMRG/medecin/tumeur_borderline.aspx .
Poncelet C, Fauvet R, Boccara J, Daraï E. Recurrence after cystectomy for borderline ovarian tumors: results of a French multicenter study. Ann Surg Oncol. 2006;13:565–71. https://doi.org/10.1245/ASO.2006.12.024 .
doi: 10.1245/ASO.2006.12.024 pubmed: 16491337
Fauvet R, Boccara J, Dufournet C, Poncelet C, Daraï E. Laparoscopic management of borderline ovarian tumors: results of a French multicenter study. Ann Oncol. 2005;16:403–10. https://doi.org/10.1093/annonc/mdi083 .
doi: 10.1093/annonc/mdi083 pubmed: 15653700
Delle Marchette M, Ceppi L, Andreano A, Bonazzi CM, Buda A, Grassi T, et al. Oncologic and fertility impact of surgical approach for borderline ovarian tumours treated with fertility sparing surgery. Eur J Cancer Oxf Engl. 1990;111:61–8.
doi: 10.1016/j.ejca.2019.01.021
Song T, Kim MK, Jung YW, et al. Minimally invasive compared with open surgery in patients with borderline ovarian tumors. Gynecol Oncol. 2017;145:508–12. https://doi.org/10.1016/j.ygyno.2017.03.019 .
doi: 10.1016/j.ygyno.2017.03.019 pubmed: 28381342
Lenhard MS, Mitterer S, Kümper C, et al. Long-term follow-up after ovarian borderline tumor: relapse and survival in a large patient cohort. Eur J Obstet Gynecol Reprod Biol. 2009;145:189–94. https://doi.org/10.1016/j.ejogrb.2009.04.031 .
doi: 10.1016/j.ejogrb.2009.04.031 pubmed: 19477060
McCluggage WG. Ovarian borderline tumours: a review with comparison of serous and mucinous types. Diagn Histopathol. 2014;20:333–50.
doi: 10.1016/j.mpdhp.2014.07.001
Song T, Kim MK, Jung YW, et al. The role of appendectomy in patients with mucinous borderline ovarian tumors. Eur J Obstet Gynecol Reprod Biol. 2018;229:112–6. https://doi.org/10.1016/j.ejogrb.2018.06.034 .
doi: 10.1016/j.ejogrb.2018.06.034 pubmed: 30145525
Matsuo K, Machida H, Takiuchi T, et al. Role of hysterectomy and lymphadenectomy in the management of early-stage borderline ovarian tumors. Gynecol Oncol. 2017;144:496–502. https://doi.org/10.1016/j.ygyno.2017.01.019 .
doi: 10.1016/j.ygyno.2017.01.019 pubmed: 28131526 pmcid: 7526042
Helpman L, Yaniv A, Beiner ME, et al. Fertility preservation in women with borderline ovarian tumors: how does it impact disease outcome? A cohort study. Acta Obstet Gynecol Scand. 2017;96:1300–6. https://doi.org/10.1111/aogs.13203 .
doi: 10.1111/aogs.13203 pubmed: 28815550
Ouldamer L, Bendifallah S, Nikpayam M, et al. Improving the clinical management of women with borderline tumours: a recurrence risk scoring system from a French multicentre study. BJOG Int J Obstet Gynaecol. 2017;124:937–44. https://doi.org/10.1111/1471-0528.14577 .
doi: 10.1111/1471-0528.14577
Shim SH, Kim SN, Jung PS, Dong M, Kim JE, Lee SJ. Impact of surgical staging on prognosis in patients with borderline ovarian tumours: a meta-analysis. Eur J Cancer. 2016;54:84–95. https://doi.org/10.1016/j.ejca.2015.11.005 .
doi: 10.1016/j.ejca.2015.11.005 pubmed: 26735354
Seong SJ, Kim DH, Kim MK, Song T. Controversies in borderline ovarian tumors. J Gynecol Oncol. 2015;26:343–9. https://doi.org/10.3802/jgo.2015.26.4.343 .
doi: 10.3802/jgo.2015.26.4.343 pubmed: 26404125 pmcid: 4620372
Querleu D, Papageorgiou Th, Lambaudie E, Sonoda Y, Narducci F, LeBlanc E. Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours. BJOG Int J Obstet Gynaecol. 2003;110:201–4. https://doi.org/10.1046/j.1471-0528.2003.02276.x .
doi: 10.1046/j.1471-0528.2003.02276.x

Auteurs

Lise Lecointre (L)

Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
I-Cube UMR 7357-Laboratoire des Sciences de L'ingénieur, de L'informatique et de L'imagerie, Université de Strasbourg, Strasbourg, France.
Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France.

Virginie Bund (V)

Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. virginie.collin@chru-strasbourg.fr.
Laboratoire d'ImmunoRhumatologie Moléculaire, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR_S 1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France. virginie.collin@chru-strasbourg.fr.
ORCID: 0000-0002-0453-8399

Eva Sangnier (E)

Department of Gynecology, Hôpitaux Universitaires de Reims, Reims, France.

Lobna Ouldamer (L)

Department of Gynecology, Hôpital Universitaire de Tours, Tours, France.

Sofiane Bendifallah (S)

Department of Gynaecology and Obstetrics, Hôpital Tenon, AP-HP, Paris, France.

Martin Koskas (M)

Department of Gynecology, Hôpital Bichat, AP-HP, Paris, France.

Pierre-Adrien Bolze (PA)

Gynecological Surgery Service, CHU Lyon-Sud, Pierre-Bénite, Lyon, France.

Pierre Collinet (P)

Department of Gynecological Surgery, Hôpital Jeanne De Flandre, CHRU, Lille, France.

Geoffroy Canlorbe (G)

Department of Gynecologic and Breast Surgery and Oncology, Hôpital la Pitié Salpétrière, AP-HP, Paris, France.

Cyril Touboul (C)

Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France.

Cyrille Huchon (C)

Department of Gynecology, Centre Hospitalier de Poissy, Poissy, France.

Charles Coutant (C)

Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, Dijon, France.

Emilie Faller (E)

Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Thomas Boisramé (T)

Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Justine Gantzer (J)

Department of Medical Oncology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Martin Demarchi (M)

Medical Oncology Department, Centre Paul Strauss, Strasbourg, France.

Vincent Lavoué (V)

Department of Gynecologic Surgery, Hôpital Universitaire de Rennes, Rennes, France.

Chérif Akladios (C)

Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

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Classifications MeSH

questionsmedicales.fr › Maladies endocriniennes › Troubles gonadiques › Maladies ovariennes › Tumeurs de l'ovaire › Carcinome épithélial de l'ovaire › Status of Surgical Management of Borderline...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Status of Surgical Management of Borderline...
questionsmedicales.fr › Régions géographiques › Europe › France › Status of Surgical Management of Borderline...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Status of Surgical Management of Borderline...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › Status of Surgical Management of Borderline...
questionsmedicales.fr › Diagnostic › Pronostic › Stadification tumorale › Status of Surgical Management of Borderline...
questionsmedicales.fr › Maladies endocriniennes › Troubles gonadiques › Maladies ovariennes › Tumeurs de l'ovaire › Status of Surgical Management of Borderline...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Status of Surgical Management of Borderline...