Sofiane Bendifallah1,2,3,4, Myriam Nikpayam5,6,7, Marcos Ballester5,6,7,8, Catherine Uzan9,10,11, Raffaele Fauvet12, Philippe Morice9,10,11, Emile Darai5,6,7,8. 1. Department of Obstetrics and Gynaecology, University Hospital of Tenon, Paris, France. sofiane.bendifallah@tnn.aphp.fr. 2. Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France. sofiane.bendifallah@tnn.aphp.fr. 3. Institut Universitaire de Cancérologie, Paris, France. sofiane.bendifallah@tnn.aphp.fr. 4. INSERM UMR_S 707, "Epidemiology, Information Systems, Modeling", University Pierre and Marie Curie, Paris, France. sofiane.bendifallah@tnn.aphp.fr. 5. Department of Obstetrics and Gynaecology, University Hospital of Tenon, Paris, France. 6. Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France. 7. Institut Universitaire de Cancérologie, Paris, France. 8. INSERM UMR_S 938, Université Pierre et Marie Curie, Paris, France. 9. Department of Gynaecological Surgery, Institut Gustave Roussy, Villejuif, France. 10. INSERM U 10-30, Institut Gustave Roussy, Villejuif, France. 11. Université Paris-Sud, Le Kremlin Bicêtre, France. 12. Department of Obstetrics and Gynaecology, University Hospital of Caen, Caen, France.
Abstract
BACKGROUND: Surgical management of borderline ovarian tumors (BOTs) is similar to that of ovarian cancer apart from lymphadenectomy. However, the complete procedure including peritoneal washing, infracolic omentectomy and random peritoneal biopsies remains a subject of controversy especially in presumed early stage BOTs. To evaluate the prognostic value of complete surgical staging on recurrence rates, recurrence free (RFS) and overall survival (OS) in a multicentre cohort of BOTs. METHODS: This retrospective multicentre study included 428 patients with BOTs diagnosed from January 1980 to December 2008. Survival estimates were based on Kaplan-Meier calculations and RFS defined as the time from the date of surgery to the date of recurrence. RESULTS: The median time of follow-up was 94.9 months (range: 60.00-207.3). The overall recurrence rate was 23.8 %. There was no difference in 5-year RFS between patients with and without complete surgical staging 78.1 % (95 % CI 68.9-88.6) and 70.9 % (95 % CI 64.6-77.8), (p = 0.0806). In the whole cohort, 5-year OS was higher for patients with complete surgical staging 98.4 % (95 % CI 96.8-1.0) and 93.8 % (95 % CI 88.1-1), (p = 0.0182) but this difference was not significant for patients with FIGO stage I 98.6 % (95 % CI 96.7-1) and 92.7 % (95 % CI 83.4-1.0), p = 0.1275, respectively. CONCLUSIONS: Complete staging surgery should be considered as a cornerstone treatment for patients with advanced stage BOT but not for those with stage I disease.
BACKGROUND: Surgical management of borderline ovarian tumors (BOTs) is similar to that of ovarian cancer apart from lymphadenectomy. However, the complete procedure including peritoneal washing, infracolic omentectomy and random peritoneal biopsies remains a subject of controversy especially in presumed early stage BOTs. To evaluate the prognostic value of complete surgical staging on recurrence rates, recurrence free (RFS) and overall survival (OS) in a multicentre cohort of BOTs. METHODS: This retrospective multicentre study included 428 patients with BOTs diagnosed from January 1980 to December 2008. Survival estimates were based on Kaplan-Meier calculations and RFS defined as the time from the date of surgery to the date of recurrence. RESULTS: The median time of follow-up was 94.9 months (range: 60.00-207.3). The overall recurrence rate was 23.8 %. There was no difference in 5-year RFS between patients with and without complete surgical staging 78.1 % (95 % CI 68.9-88.6) and 70.9 % (95 % CI 64.6-77.8), (p = 0.0806). In the whole cohort, 5-year OS was higher for patients with complete surgical staging 98.4 % (95 % CI 96.8-1.0) and 93.8 % (95 % CI 88.1-1), (p = 0.0182) but this difference was not significant for patients with FIGO stage I 98.6 % (95 % CI 96.7-1) and 92.7 % (95 % CI 83.4-1.0), p = 0.1275, respectively. CONCLUSIONS: Complete staging surgery should be considered as a cornerstone treatment for patients with advanced stage BOT but not for those with stage I disease.