977P - Prognostic factors after conservative treatment of a large series of “stage I” serous borderline ovarian tumors

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Ovarian Cancer
Presenter Philippe Morice
Authors P. Morice1, A. Kane1, E. Muller1, R. Fauvet2, S. Gouy1, P. Pautier3, C. Lhomme4, E. Darai5, P. Duvillard1, C. Uzan1
  • 1Surgery, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 2Obstetrics Gynecology, CHU, Amiens/FR
  • 3Medecine Oncologique, Institut de Canc, FR-94805 - Villejuif CEDEX/FR
  • 4Consultation De Gynécologie Médicale, Institut de Canc, FR-94805 - Villejuif CEDEX/FR
  • 5Obstetrics & Gynecology, Hopital Tenon, Paris/FR

Abstract

Objectives

The aim of this study was to evaluate the prognostic factors of recurrence after conservative treatment of a large series of “apparent” stage I serous borderline ovarian tumors (SBOT).

Methods

A review of 119 patients treated conservatively between 2000 and 2010 with data on the follow-up. All pathological slides were reviewed by the same expert pathologist. Prognostic factors of recurrences were studied (age, histologic subtypes, surgical procedures used … ).

Results

Conservative procedures were: unilateral cystectomy/UC (n = 43; 36%); unilateral salpingo-oophorectomy/USO (n = 50; 42%); bilateral cystectomy (n = 11; 9%) and USO + CC (n = 15; 13%). Fourteen patients underwent complete peritoneal staging. Stages distributions were: IA (n = 80; 67%); IB (n = 18; 15%) & IC (n = 21; 18%). Twenty-six patients had bilateral tumors. Respectively 21 (18%) & 13 (11%) had stromal microinvasion and/or micropapillary pattern. With a median follow-up of 45 months, 40 (33%) patients recurred (in whom 10 had peritoneal recurrence under the form of non invasive implants during the 1st recurrence). Two of these 40 recurrent patients had evolution in the form of invasive recurrence (during the 2nd or 3rd recurrence): 1 in remaining ovary & 1 in the peritoneum. None patient died from disease. Only 2 prognostic factors of recurrence were identified in multivariate analysis: the young age of the patients (< 30 years old) & the bilaterality of the tumours. None of the others factors studied had impact on the rate of recurrence.

Conclusions

In this series (representing the largest series reported of conservative management of stage I SBOT), the risk of recurrence is not related to the histologic patterns of the tumor (micropapillary, stromal microinvasion) nor to the surgical procedures used (type of conservative approach, the use of staging surgery, the use of laparoscopic approach). The rate of invasive recurrence is very rare in stage I SBOT (2 cases in this series). Young age (< 30 years old) and bilaterality of the tumors are risk factors of recurrence suggesting that improvement of the fertility management (before potential recurrence) should be improved particularly in theses subgroup of patients.

Disclosure

All authors have declared no conflicts of interest.