Giulio Ricotta1, Amandine Maulard1, Massimo Candiani2, Stephanie Scherrier1, 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. Department of Medical Oncology, Gustave-Roussy, Villejuif, France. 5. Department of 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: 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: 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: 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: 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.
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: 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: 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: 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.
Authors: Y Yokoyama; T Moriya; T Takano; T Shoji; O Takahashi; K Nakahara; H Yamada; N Yaegashi; K Okamura; T Izutsu; T Sugiyama; T Tanaka; H Kurachi; A Sato; T Tase; H Mizunuma Journal: Br J Cancer Date: 2006-06-05 Impact factor: 7.640