Giulio Ricotta1, Amandine Maulard1, Massimo Candiani2, Catherine Genestie3, Patricia Pautier4, Alexandra Leary4, Cyrus Chargari5, Giorgia Mangili2, Philippe Morice6,7, Sébastien Gouy1. 1. Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France. 2. IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy. 3. Department of Pathology, Gustave-Roussy, Villejuif, France. 4. Medical Oncology, Gustave-Roussy, Villejuif, France. 5. Radiation Oncology, Gustave-Roussy, Villejuif, France. 6. Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France. Philippe.MORICE@gustaveroussy.fr. 7. Paris Sud University Kremlin-Bicêtre, Le Kremlin-Bicêtre, France. Philippe.MORICE@gustaveroussy.fr.
Abstract
BACKGROUND: Clear cell borderline ovarian tumor (CCBOT) is one of the rarest subtypes of borderline ovarian malignancies. The aim of this study was to determine the prognosis of a series of CCBOT. PATIENTS AND METHODS: A retrospective review of patients with CCBOT treated or referred to our institutions. A centralized histological review by a reference pathologist and data on the clinical characteristics, management, and outcomes of patients were required for inclusion. RESULTS: Nineteen patients were identified. Median age was 62 (range 36-83) years. Four patients underwent a conservative surgery and 14 a bilateral salpingo-oophorectomy +/- hysterectomy (unknown in 1 case). One patient had bilateral tumor, and all cases were stage-I disease. All CCBOTs showed an adenofibromatous pattern. Stromal microinvasion was observed in seven cases and intraepithelial carcinoma in two cases. Endometriosis was histologically associated in one case. The median follow-up was 76 (range 6-231) months. No recurrence occurred. Two patients died of intercurrent disease. CONCLUSIONS: Peritoneal staging procedures should always be associated, but restaging surgery could be omitted if there was no suspicious lesion in the peritoneum during initial surgery, since all patients reported had stage-I disease. Fertility-sparing surgery appears to be a safe alternative in young patients. Synchronous endometrial disorders with atypia are infrequent. Prognosis is generally excellent, and long-term risk of recurrence is low. The two recurrences described in literature occurred in stage-IC diseases, highlighting the importance of avoiding perioperative rupture.
BACKGROUND: Clear cell borderline ovarian tumor (CCBOT) is one of the rarest subtypes of borderline ovarian malignancies. The aim of this study was to determine the prognosis of a series of CCBOT. PATIENTS AND METHODS: A retrospective review of patients with CCBOT treated or referred to our institutions. A centralized histological review by a reference pathologist and data on the clinical characteristics, management, and outcomes of patients were required for inclusion. RESULTS: Nineteen patients were identified. Median age was 62 (range 36-83) years. Four patients underwent a conservative surgery and 14 a bilateral salpingo-oophorectomy +/- hysterectomy (unknown in 1 case). One patient had bilateral tumor, and all cases were stage-I disease. All CCBOTs showed an adenofibromatous pattern. Stromal microinvasion was observed in seven cases and intraepithelial carcinoma in two cases. Endometriosis was histologically associated in one case. The median follow-up was 76 (range 6-231) months. No recurrence occurred. Two patients died of intercurrent disease. CONCLUSIONS: Peritoneal staging procedures should always be associated, but restaging surgery could be omitted if there was no suspicious lesion in the peritoneum during initial surgery, since all patients reported had stage-I disease. Fertility-sparing surgery appears to be a safe alternative in young patients. Synchronous endometrial disorders with atypia are infrequent. Prognosis is generally excellent, and long-term risk of recurrence is low. The two recurrences described in literature occurred in stage-IC diseases, highlighting the importance of avoiding perioperative rupture.
Authors: Catherine Uzan; Marion Dufeu-Lefebvre; Raffaele Fauvet; Sebastien Gouy; Pierre Duvillard; Emile Darai; Philippe Morice Journal: Int J Gynecol Cancer Date: 2012-07 Impact factor: 3.437