Endometrioid Borderline Ovarian Tumor: Clinical Characteristics, Prognosis, and Managements.
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:
Sep 2022
Sep 2022
Historique:
received:
12
01
2022
accepted:
27
04
2022
pubmed:
20
5
2022
medline:
11
8
2022
entrez:
19
5
2022
Statut:
ppublish
Résumé
Endometrioid borderline ovarian tumor (EBOT) is a rare subtype of borderline ovarian malignancies. This study was designed to determine the prognosis of a series of EBOT. This is a retrospective review of patients with EBOT treated in or referred to our institutions and a centralized, histological review by a reference pathologist. Data on the clinical characteristics, management (surgical and medical), and oncologic outcomes of patients were required for inclusion. Forty-eight patients were identified. Median age was 52 years (range 14-89). Fourteen patients underwent a conservative surgery and 32 a bilateral salpingo-oophorectomy (unknown in 2 cases). Two patients had bilateral tumors. Forty-three patients had stage I disease, and five patients had stage II disease (10%). Stromal microinvasion and intraepithelial carcinoma was observed in 6 (12%) and 13 (27%) patients respectively. Endometriosis was histologically associated in 12 patients (25%). Synchronous endometrial disease was found in 7 (24%) of 29 patients with endometrial histological evaluation. The median follow-up was 72 months (range 6-146). Two patients developed a recurrence after cystectomy in form of borderline disease (5%). No death related to EBOT occurred. Peritoneal restaging surgery should be performed if not realized initially, because 5% of EBOTS are diagnosed at stage II-III. Fertility-sparing surgery seems a safe option in selected patients. Because synchronous endometrial diseases, including endometrial carcinoma are frequent, systematic hysterectomy (or endometrial sampling in case of fertility-sparing surgery) is mandatory. Prognosis is generally excellent. Recurrence is a rare event (6%), but it can occur in the form of invasive disease.
Sections du résumé
BACKGROUND
BACKGROUND
Endometrioid borderline ovarian tumor (EBOT) is a rare subtype of borderline ovarian malignancies. This study was designed to determine the prognosis of a series of EBOT.
METHODS
METHODS
This is a retrospective review of patients with EBOT treated in or referred to our institutions and a centralized, histological review by a reference pathologist. Data on the clinical characteristics, management (surgical and medical), and oncologic outcomes of patients were required for inclusion.
RESULTS
RESULTS
Forty-eight patients were identified. Median age was 52 years (range 14-89). Fourteen patients underwent a conservative surgery and 32 a bilateral salpingo-oophorectomy (unknown in 2 cases). Two patients had bilateral tumors. Forty-three patients had stage I disease, and five patients had stage II disease (10%). Stromal microinvasion and intraepithelial carcinoma was observed in 6 (12%) and 13 (27%) patients respectively. Endometriosis was histologically associated in 12 patients (25%). Synchronous endometrial disease was found in 7 (24%) of 29 patients with endometrial histological evaluation. The median follow-up was 72 months (range 6-146). Two patients developed a recurrence after cystectomy in form of borderline disease (5%). No death related to EBOT occurred.
CONCLUSIONS
CONCLUSIONS
Peritoneal restaging surgery should be performed if not realized initially, because 5% of EBOTS are diagnosed at stage II-III. Fertility-sparing surgery seems a safe option in selected patients. Because synchronous endometrial diseases, including endometrial carcinoma are frequent, systematic hysterectomy (or endometrial sampling in case of fertility-sparing surgery) is mandatory. Prognosis is generally excellent. Recurrence is a rare event (6%), but it can occur in the form of invasive disease.
Identifiants
pubmed: 35590116
doi: 10.1245/s10434-022-11893-7
pii: 10.1245/s10434-022-11893-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5894-5903Informations de copyright
© 2022. Society of Surgical Oncology.
Références
Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO Classification of Tumours of Female Reproductive Organs, 4
Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist. 2012;17(12):1515–33. https://doi.org/10.1634/theoncologist.2012-0139 .
doi: 10.1634/theoncologist.2012-0139
pubmed: 23024155
pmcid: 3528384
Uzan C, Berretta R, Rolla M, et al. Management and prognosis of endometrioid borderline tumors of the ovary. Surg Oncol. 2012;21(3):178–84. https://doi.org/10.1016/j.suronc.2012.02.002 .
doi: 10.1016/j.suronc.2012.02.002
pubmed: 22418038
Bell DA, Scully RE. Atypical and borderline endometrioid adenofibromas of the ovary. A report of 27 cases. Am J Surg Pathol. 1985;9(3):205–14. https://doi.org/10.1097/00000478-198503000-00004 .
doi: 10.1097/00000478-198503000-00004
pubmed: 3993832
Bell KA, Kurman RJ. A clinicopathologic analysis of atypical proliferative (borderline) tumors and well-differentiated endometrioid adenocarcinomas of the ovary. Am J Surg Pathol. 2000;24(11):1465–79.
doi: 10.1097/00000478-200011000-00002
Yokoyama Y, Moriya T, Takano T, et al. Clinical outcome and risk factors for recurrence in borderline ovarian tumours. Br J Cancer. 2006;94(11):1586–91. https://doi.org/10.1038/sj.bjc.6603139 .
doi: 10.1038/sj.bjc.6603139
pubmed: 16685277
pmcid: 2361313
Zheng JS, Ji ZJ, Yong LZ, et al. Safety and fertility outcomes after the conservative treatment of endometrioid borderline ovarian tumours. BMC Cancer. 2018;18(1):1160. https://doi.org/10.1186/s12885-018-5091-1 .
doi: 10.1186/s12885-018-5091-1
Nakagawa E, Abiko K, Kido A, et al. Four cases of endometrioid borderline ovarian tumour: case reports and literature review. BJR Case Rep. 2017;4(1):20170062. https://doi.org/10.1259/bjrcr.20170062 .
doi: 10.1259/bjrcr.20170062
pubmed: 30363172
pmcid: 6159154
Roth LM, Czernobilsky B, Langley FA. Ovarian endometrioid adenofibromatous and cystadenofibromatous tumors: benign, proliferating, and malignant. Cancer. 1981;48(8):1838–45. https://doi.org/10.1002/1097-0142(19811015)48:8%3c1838::aid-cncr2820480822%3e3.0.co;2-r .
doi: 10.1002/1097-0142(19811015)48:8<1838::aid-cncr2820480822>3.0.co;2-r
pubmed: 7284979
Roth LM, Emerson RE, Ulbright TM. Ovarian endometrioid tumors of low malignant potential: a clinicopathologic study of 30 cases with comparison to well-differentiated endometrioid adenocarcinoma. Am J Surg Pathol. 2003;27(9):1253–9. https://doi.org/10.1097/00000478-200309000-00009 .
doi: 10.1097/00000478-200309000-00009
pubmed: 12960810
Russell P. The pathological assessment of ovarian neoplasms. II: The proliferating “epithelial” tumours. Pathology (Phila). 1979;11(2):251–82. https://doi.org/10.3109/00313027909061951 .
doi: 10.3109/00313027909061951
Snyder RR, Norris HJ, Tavassoli F. Endometrioid proliferative and low malignant potential tumors of the ovary. A clinicopathologic study of 46 cases. Am J Surg Pathol. 1988;12(9):661–71. https://doi.org/10.1097/00000478-198809000-00002 .
doi: 10.1097/00000478-198809000-00002
pubmed: 3414893
Yüksel D, Çakır C, Kimyon Cömert G, et al. Uncommon borderline ovarian tumours: A clinicopathologic study of seventeen patients. J Turk Ger Gynecol Assoc. 2019;20(4):224–30. https://doi.org/10.4274/jtgga.galenos.2018.2018.0098 .
doi: 10.4274/jtgga.galenos.2018.2018.0098
pubmed: 30178748
pmcid: 6883761
Kliman L, Rome RM, Fortune DW. Low malignant potential tumors of the ovary: a study of 76 cases. Obstet Gynecol. 1986;68(3):338–44. https://doi.org/10.1097/00006250-198609000-00009 .
doi: 10.1097/00006250-198609000-00009
pubmed: 3737056
Vo TM, Duong KA, Tran LT, Bui TC. Recurrence rate and associated factors of borderline ovarian tumors in the south of Vietnam. J Obstet Gynaecol Res. 2019;45(10):2055–61. https://doi.org/10.1111/jog.14072 .
doi: 10.1111/jog.14072
Ji H, Yliskoski M, Anttila M, Syrjänen K, Saarikoski S. Management of stage-I borderline ovarian tumors. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 1996;54(1):37–44. https://doi.org/10.1016/0020-7292(96)02674-4 .
doi: 10.1016/0020-7292(96)02674-4
Zhang W, Jia S, Xiang Y, Yang J, Jia C, Leng J. Comparative study of endometrioid borderline ovarian tumor with and without endometriosis. J Ovarian Res. 2018;11(1):67. https://doi.org/10.1186/s13048-018-0440-x .
doi: 10.1186/s13048-018-0440-x
pubmed: 30098603
pmcid: 6087536
Ricotta G, Maulard A, Genestie C, et al. Brenner borderline ovarian tumor: a case series and literature review. Ann Surg Oncol. 2021;28(11):6714–20. https://doi.org/10.1245/s10434-021-09879-y .
doi: 10.1245/s10434-021-09879-y
Ricotta G, Maulard A, Candiani M, et al. Clear cell borderline ovarian tumor: clinical characteristics, prognosis, and management. Ann Surg Oncol. 2022;29(2):1165–70. https://doi.org/10.1245/s10434-021-10776-7 .
doi: 10.1245/s10434-021-10776-7
pubmed: 34596794