976P - A semi-prospective trial to determine the outcome of borderline ovarian tumor patients. Results of robot, a study of the ago study group

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Ovarian Cancer
Presenter Hans-Joachim Lueck
Authors H. Lueck1, N. Ewald-Riegler2, N. De Gregorio3, A. Reuss4, S. Mahner5, C. Fotopoulou6, F. Kommoss7, B. Schmalfeldt8, S. Hauptmann9, A. Du Bois10
  • 1Gynäkologisch-Onkologische Schwerpunktpraxis Hannover, 30177 - Hannover/DE
  • 2Klinik Für Gynäkologie U. Gynäkologische Onkologie, HSK Wiesbaden, Wiesbaden/DE
  • 3Frauenklinik, Universitätsklinikum Ulm, Ulm/DE
  • 4Studienzentren, Koordinierungszentrum für Klinische Studien, Marburg/DE
  • 5Dept Of Gynecology And Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg/DE
  • 6Frauenklinik, Charité, Campus Virchow Klinikum, Berlin/DE
  • 7Gyn Tumors, Institut für Pathologie, Mannheim/DE
  • 8Frauen- Und Poliklinik, Klinikum rechts der Isar der Technischen Universität, München/DE
  • 9Gyn Tumors, Institut für Pathologie Allgäu-Oberschwaben, Wangen/DE
  • 10Klinik Für Gynäkologische Onkologie, Kliniken Essen-Mitte, Essen/DE

Abstract

Background

Borderline ovarian tumors (BOT) are a rare entity, current standard of care is based on the available data of predominantly small retrospective trials. Therefore we performed a pattern of care study including central pathology review.

Methods

All consecutive patients diagnosed with BOT 1998-2008 in 24 German institutions were included. Tumor samples were sent for central histopathological review to experienced pathologists, clinical data were collected and patient follow-up was updated.

Results

Pathological review was obtained in 1,042 of 1,236 pts resulting in 950 confirmed BOT cases analyzed here. Under- and overdiagnosis occurred in 5.0% and 6.2% of cases. Median age was 49 years; 82% of patients had FIGO stage I disease; serous type (S-BOT) was diagnosed in 68% and mucinous type (M-BOT) in 31%. Primary/re-staging surgery led to complete debulking in 92% of pts (residual disease 1.3%, unknown 6.4%). Adjuvant chemotherapy was given to 33 (3.5%) pts only. 166 (17%) underwent fertility preserving surgery and 31 (19%) of these patients had documented pregnancies thereafter. Overall, 74 (7.8%) pts experienced relapse and 43 (4.5%) died, transformation to invasive carcinoma occurred in 30% of the relapses. Inadequate surgical staging, residual tumor, fertility sparing surgery and higher FIGO stage were associated with shorter progression-free survival. No differences were observed for laparatomy vs. laparoscopy as initial surgical approach or adjuvant chemotherapy.

Conclusions

To this day, this is the largest data set available for this entity. Prognosis of BOT is good even without adjuvant therapy if correct surgical staging is performed. Both tumor characteristics and treatment variables had a significant impact on relapse rate and outcome. In contrast to previous data, transformation to invasive carcinoma occurred in a significant amount of relapse cases.

Disclosure

All authors have declared no conflicts of interest.