Borderline ovarian tumors: features and controversial aspects

Eur J Obstet Gynecol Reprod Biol. 2013 Mar;167(1):86-9. doi: 10.1016/j.ejogrb.2012.11.002. Epub 2012 Dec 5.

Abstract

Objective: To investigate features and controversial aspects of the borderline ovarian tumor (BOT), a neoplasm with favorable prognosis representing 10-15% of epithelial ovarian tumors.

Study design: : We retrospectively studied all patients treated at our institution from 2000 to 2010 taking into account the age, the stage, the type of surgery, the tumor size, the symptoms, the pre- and post-intervention tumor marker levels (CA125, CA19.9, CA15.3 and CEA), the presence of recurrence, the overall survival (OS), the progression-free survival (PFS).

Results: A total of 43 patients were identified. The median age was 49 years (range: 15-82 years). The most frequent FIGO stage was IA (74% of the cases) with a prevalence of serous histotype, and 49% of the patients were asymptomatic. The CA125 level was abnormal in 55% of the patients before surgery, returning to the normal range in all cases after tumor removal. The PFS was 96% and 77% at five and sixty months respectively.

Conclusion: The BOT is closer to a benign than to a malignant tumor in the early stages, when confined to the ovary (IA and IB). In these stages conservative surgery is safe and advisable for women seeking offspring. In the other stages the need for a careful and long-term follow-up arises. CA125, despite its modest sensitivity and specificity, has a role in the follow-up of BOT.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • CA-125 Antigen / blood
  • CA-19-9 Antigen / blood
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Membrane Proteins / blood
  • Menstruation Disturbances / etiology
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms, Cystic, Mucinous, and Serous / blood
  • Neoplasms, Cystic, Mucinous, and Serous / pathology*
  • Neoplasms, Cystic, Mucinous, and Serous / surgery*
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery*
  • Pelvic Pain / etiology
  • Retrospective Studies
  • Survival Rate
  • Uterine Hemorrhage / etiology
  • Young Adult

Substances

  • CA-125 Antigen
  • CA-19-9 Antigen
  • MUC16 protein, human
  • Membrane Proteins