DOI QR코드

DOI QR Code

Is Target Oriented Surgery Sufficient with Borderline Ovarian Tumors? - Role of Accompanying Pathologies

  • Gungor, Tayfun (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Cetinkaya, Nilufer (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Yalcin, Hakan (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Ozdal, Bulent (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Ozgu, Emre (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Baser, Eralp (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Yilmaz, Nafiye (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Caglar, Mete (Department of Obstetrics and Gynecologic, Faculty of Medicine, Duzce University) ;
  • Zergeroglu, Sema (Department of Pathology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Erkaya, Salim (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital)
  • Published : 2014.08.30

Abstract

Background: There are limited data in the literature related to concomitant genital or extra-genital organ pathologies in patients with borderline ovarian tumors (BOTs). The aim of this study was to evaluate our experience with 183 patients to draw attention to the accompanying organ pathologies with BOTs. Materials and Methods: One hundred eighty-three patients with BOTs, diagnosed and/or treated in our center between January of 2000 and March of 2013 were evaluated retrospectively. Data related to age, tumor histology, lesion side, disease stage, accompanying incidental ipsilateral and/or contralateral ovarian pathologies, treatment approaches, and follow-up periods were investigated. Incidental gynecologic and non-gynecologic concomitant organ pathologies were also recorded. Results: The mean age at diagnosis was 40.6 years (range: 17-78). Ninety-five patients (51%) were ${\leq}40$ years. A hundred and forty-seven patients (80%) were at stage IA of the disease. The most common type of BOT was serous in histology. Non-invasive tumor implants were diagnosed in 4% and uterine involvement was found 2% among patients who underwent hysterectomies. There were 12 patients with positive peritoneal washings. Only 17 and 84 patients respectively had concomitant ipsilateral and concomitant contralateral incidental ovarian pathologies. The most common type of uterine, appendicular and omental pathologies were chronic cervicitis, lymphoid hyperplasia and chronic inflammatory reaction. Conclusions: According to our findings most of accompanying pathologies for BOT are benign in nature. Nevertheless, there were additional malignant diseases necessitating further therapy. We emphasize the importance of the evaluation of all abdominal organs during surgery.

Keywords

References

  1. Arun-Muthuvel V, Jaya V (2014). Pre-operative evaluation of ovarian tumors by risk of malignancy index, CA125 and ultrasound. Asian Pac J Cancer Prev, 15, 2929-32. https://doi.org/10.7314/APJCP.2014.15.6.2929
  2. Ayhan A, Guvendag Guven ES, Guven S, et al (2005). Recurrence and prognostic factors in borderline ovarian tumors. Gynecol Oncol, 98, 439-45. https://doi.org/10.1016/j.ygyno.2005.05.033
  3. Devan SM, Pailoor J, Sthaneshwar P, et al (2013). Pattern of tissue expression of CA-125 and HE4 in primary epithelial ovarian tumours and correlation with serum CA-125 levels. Asian Pac J Cancer Prev, 14, 4545-8. https://doi.org/10.7314/APJCP.2013.14.8.4545
  4. Gotlieb WH, Chetrit A, Menczer J, et al (2005). Demographic and genetic characteristics of patients with borderline ovarian tumors as compared to early stage invasive ovarian cancer. Gynecol Oncol, 97, 780-3. https://doi.org/10.1016/j.ygyno.2005.02.022
  5. Gungor T, Altinkaya SO, Sirvan L, et al (2011). Coexistence of borderline ovarian epithelial tumor, primary pelvic hydatid cyst, and lymphoepithelioma-like gastric carcinoma. Taiwan J Obstet Gynecol, 50, 201-4. https://doi.org/10.1016/j.tjog.2009.10.005
  6. Kanat-Pektas M, Ozat M, Gungor T, et al (2011a). Fertility outcome after conservative surgery for borderline ovarian tumors: a single center experience. Arch Gynecol Obstet, 284, 1253-8. https://doi.org/10.1007/s00404-010-1804-7
  7. Kanat-Pektas M, Ozat M, Gungor T, et al (2011b). Complete lymph node dissection: is it essential for the treatment of borderline epithelial ovarian tumors? Arch Gynecol Obstet, 283, 879-84. https://doi.org/10.1007/s00404-010-1539-5
  8. Kanat-Pektas M, Yenicesu O, Gungor T, et al (2010). Predictive power of sexual hormones and tumor markers in endometrial cancer. Arch Gynecol Obstet, 281, 709-15. https://doi.org/10.1007/s00404-009-1228-4
  9. Karimi Zarchi M, Mousavi A, Gilani MM, et al (2011). Fertility sparing treatments in young patients with gynecological cancers: Iranian experience and literature review. Asian Pac J Cancer Prev, 12, 1887-92.
  10. Li L, Xu Y, Yu CX (2012). Proteomic analysis of serum of women with elevated Ca-125 to differentiate malignant from benign ovarian tumors. Asian Pac J Cancer Prev, 13, 3265-70. https://doi.org/10.7314/APJCP.2012.13.7.3265
  11. McCluggage WG (2010). The pathology of and controversial aspects of ovarian borderline tumours. Curr Opin Oncol, 22, 462-72. https://doi.org/10.1097/CCO.0b013e32833b0dc1
  12. Menczer J, Chetrit A, Sadetzki S (2012). The effect of hysterectomy on survival of patients with borderline ovarian tumors. Gynecol Oncol, 125, 372-5. https://doi.org/10.1016/j.ygyno.2012.02.017
  13. Messalli EM, Grauso F, Balbi G, et al (2013). Borderline ovarian tumors: features and controversial aspects. Eur J Obstet Gynecol Reprod Biol, 167, 86-9. https://doi.org/10.1016/j.ejogrb.2012.11.002
  14. Moolthiya W, Yuenyao P (2009). The risk of malignancy index (RMI) in diagnosis of ovarian malignancy. Asian Pac J Cancer Prev, 10, 865-8.
  15. Nam JH (2010). Borderline ovarian tumors and fertility. Curr Opin Obstet Gynecol, 22, 227-34. https://doi.org/10.1097/GCO.0b013e3283384928
  16. Park JY, Kim DY, Kim JH, et al (2009). Surgical management of borderline ovarian tumors: The role of fertility-sparing surgery. Gynecol Oncol, 113, 75-82. https://doi.org/10.1016/j.ygyno.2008.12.034
  17. Poncelet C, Fauvet R, Yazbeck C, et al (2010). Impact of serum tumor marker determination on the management of women with borderline ovarian tumors: multivariate analysis of a French multicentre study. Eur J Surg Oncol, 36, 1066-72. https://doi.org/10.1016/j.ejso.2010.07.004
  18. Romagnolo C, Gadducci A, Sartori E, et al (2006). Management of borderline ovarian tumors: results of an Italian multicenter study. Gynecol Oncol, 101, 255-60. https://doi.org/10.1016/j.ygyno.2005.10.014
  19. Seidman JD, Soslow RA, Vang R, et al (2004). Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrative images. Hum Pathol, 35, 918-33. https://doi.org/10.1016/j.humpath.2004.03.004
  20. Suprasert P, Khunamornpong S, Phusong A, et al (2008). Accuracy of intra-operative frozen sections in the diagnosis of ovarian masses. Asian Pac J Cancer Prev, 9, 737-40.
  21. Tinelli R, Malzoni M, Cosentino F, et al (2009). Feasibility, safety, and efficacy of conservative laparoscopic treatment of borderline ovarian tumors. Fertil Steril, 92, 736-41. https://doi.org/10.1016/j.fertnstert.2008.07.1716
  22. Tinelli R, Tinelli A, Tinelli FG, et al (2006). Conservative surgery for borderline ovarian tumors: a review. Gynecol Oncol, 100, 185-91. https://doi.org/10.1016/j.ygyno.2005.09.021
  23. Trope CG, Kaern J, Davidson B (2012). Borderline ovarian tumours. Best Pract Res Clin Obstet Gynaecol, 26, 325-36. https://doi.org/10.1016/j.bpobgyn.2011.12.006
  24. Winarto H, Laihad BJ, Nuranna L (2014). Modification of cutoff values for HE4, CA125, the risk of malignancy index, and the risk of malignancy algorithm for ovarian cancer detection in Jakarta, Indonesia. Asian Pac J Cancer Prev, 15, 1949-53. https://doi.org/10.7314/APJCP.2014.15.5.1949
  25. Wu TI, Lee CL, Wu MY, et al (2009). Prognostic factors predicting recurrence in borderline ovarian tumors. Gynecol Oncol, 114, 237-41. https://doi.org/10.1016/j.ygyno.2009.05.018
  26. Yinon Y, Beiner ME, Gotlieb WH, et al (2007). Clinical outcome of cystectomy compared with unilateral salpingooophorectomy as fertility-sparing treatment of borderline ovarian tumors. Fertil Steril, 88, 479-84. https://doi.org/10.1016/j.fertnstert.2006.11.128