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Clinical Management of Borderline Ovarian Tumors

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 October 2022) | Viewed by 4963

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Guest Editor
1. Department of Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France
2. Unité INSERM (Nutrition, Growth and Cancer), U1069, Tours, France
Interests: borderline ovarian tumors; ovarian cancer; cervical cancer; endometrial cancer; vulvar cancer; vaginal cancer
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Dear Colleagues,

Borderline ovarian tumors (BOTs) are rare, but have shown an increase in the global incidence, biological behavior and prognosis between benign and malignant tumors.

These tumors mostly occur in young women of reproductive age, and although they have a favorable prognosis, their management by consensus is essential to limit the risk of invasive recurrence. The global recurrence rate is estimated to be between 5% and 34%.

Controversies surround the diagnostic criteria used for their assessment, and the optimal management to minimize their risk of recurrence, especially into malignant carcinoma. Fertility preservation is considered a cornerstone in the management of young patients.

There is a similarity of histological features and survival between ovarian mucinous carcinoma (MC) with expansile invasion and ovarian mucinous borderline tumor (MBT). The prognostic outcome of MC with expansile invasion might mimic that of MBT. Recent studies have shown that ovarian borderline tumor treatment can be applied to MC treatment.

There is disagreement in the current literature on several points concerning the safest and most effective way to manage women with these pathologies.

Prof. Dr. Lobna Ouldamer
Guest Editor

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Keywords

  • borderline ovarian tumors
  • invasive recurrence
  • mucinous carcinoma with expansile invasion
  • serous borderline tumors
  • mucinous borderline tumors
  • conservative management
  • ovarian cancer

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Published Papers (2 papers)

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Research

12 pages, 1494 KiB  
Article
Presentation and Prognosis of Primary Expansile and Infiltrative Mucinous Carcinomas of the Ovary
by Marine Huin, Jerome Lorenzini, Flavie Arbion, Xavier Carcopino, Cyril Touboul, Yohann Dabi, Yohan Kerbage, Hélène Costaz, Lise Lecointre, Vincent Lavoué, Pierre-Adrien Bolze, Cyrille Huchon, Alexandre Bricou, Geoffroy Canlorbe, Camille Mimoun, Sofiane Bendifallah, Tristan Gauthier, Gilles Body and Lobna Ouldamer
J. Clin. Med. 2022, 11(20), 6120; https://doi.org/10.3390/jcm11206120 - 17 Oct 2022
Cited by 2 | Viewed by 2358
Abstract
Objective: The aim of the present study was to evaluate evolution and prognosis of mucinous ovarian carcinomas (mOC), with respect to the two invasive patterns: expansile and infiltrative invasion. Methods: This was a descriptive, retrospective, multicenter study conducted in 13 French centres from [...] Read more.
Objective: The aim of the present study was to evaluate evolution and prognosis of mucinous ovarian carcinomas (mOC), with respect to the two invasive patterns: expansile and infiltrative invasion. Methods: This was a descriptive, retrospective, multicenter study conducted in 13 French centres from 1 January 2001 to 31 December 2019. All patients operated on for epithelial ovarian neoplasia of the mucinous type (infiltrative/expansile) were included, whether the surgery was performed immediately or after neoadjuvant chemotherapy. Results: A total of 94 women with mucinous carcinomas were included in the present study. Mucinous tumours were divided into 35 expansile (37%) and 59 infiltrative (63%) mOC. There was a statistically significant difference in early and late stages at initial diagnosis between expansile and infiltrative mOC. None of the expansile mOC showed metastatic lymph nodes, whereas almost a quarter of the infiltrative mOC were metastatic to the pelvic/para-aortic region. There was a clear difference in RFS, in favour of expansile mOC, with 90% survival at 5 years, compared with 60% for infiltrative mOC. Conclusions: Although infiltrative and expansile mOC belong to the same histological family, they present many distinctions in clinical presentation, histological invasion, and disease course. Full article
(This article belongs to the Special Issue Clinical Management of Borderline Ovarian Tumors)
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16 pages, 315 KiB  
Article
Risk Factors for Recurrence of Borderline Ovarian Tumours after Conservative Surgery and Impact on Fertility: A Multicentre Study by the Francogyn Group
by Adele Ozenne, Marion De Berti, Gilles Body, Xavier Carcopino, Olivier Graesslin, Yohan Kerbage, Cherif Akladios, Cyrille Huchon, Alexandre Bricou, Camille Mimoun, Emilie Raimond and Lobna Ouldamer
J. Clin. Med. 2022, 11(13), 3645; https://doi.org/10.3390/jcm11133645 - 23 Jun 2022
Cited by 9 | Viewed by 2251
Abstract
Introduction: Borderline ovarian tumours (BOT) represent 10–20% of epithelial tumours of the ovary. Although their prognosis is excellent, the recurrence rate can be as high as 30%, and recurrence in the infiltrative form accounts for 3% to 5% of recurrences. Affecting, in one [...] Read more.
Introduction: Borderline ovarian tumours (BOT) represent 10–20% of epithelial tumours of the ovary. Although their prognosis is excellent, the recurrence rate can be as high as 30%, and recurrence in the infiltrative form accounts for 3% to 5% of recurrences. Affecting, in one third of cases, women of childbearing age, the surgical strategy with ovarian conservation is now recommended despite a significant risk of recurrence. Few studies have focused exclusively on patients who have received ovarian conservative treatment in an attempt to identify factors predictive of recurrence and the impact on fertility. The objective of this study was to identify the risk factors for recurrence of BOT after conservative treatment and the impact on fertility. Material and methods: This was a retrospective, multicentre study of women who received conservative surgery for BOT between February 1997 and September 2020. We divided the patients into two groups, the “R group” with recurrence and the “NR group” without recurrence. Results: Of 175 patients included, 35 had a recurrence (R group, 20%) and 140 had no recurrence (NR group, 80%). With a mean follow-up of 30 months (IQ 8–62.5), the overall recurrence rate was 20%. Recurrence was BOT in 17.7% (31/175) and invasive in 2.3% (4/175). The mean time to recurrence was 29.5 months (IQ 16.5–52.5). Initial complete peritoneal staging (ICPS) was performed in 42.5% of patients (n = 75). In multivariate analysis, age at diagnosis, nulliparity, advanced FIGO stage, the presence of peritoneal implants, and the presence of a micropapillary component for serous tumours were factors influencing the occurrence of recurrence. The post-surgery fertility rate was 67%. Conclusion: This multicentre study is to date one of the largest studies analysing the risk factors for recurrence of BOT after conservative surgery. Five risk factors were found: age at diagnosis, nulliparity, advanced FIGO stage, the presence of implants, and a micropapillary component. Only 25% of the patients with recurrence underwent ICPS. These results reinforce the interest of initial peritoneal staging to avoid ignoring an advanced tumour stage. Full article
(This article belongs to the Special Issue Clinical Management of Borderline Ovarian Tumors)
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