TREATMENT OUTCOMES OF BORDERLINE OVARIAN TUMORS AT VIETNAM NATIONAL CANCER HOSPITAL
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Abstract
Background: Borderline ovarian tumors (BOTs), comprising 10–20% of epithelial ovarian neoplasms, are characterized by atypical epithelial proliferation without stromal invasion and typically exhibit favorable prognosis. This study delineates the clinical and pathological characteristics of BOT patients and evaluates recurrence and survival outcomes following surgical treatment at Vietnam National Cancer Hospital.
Methods: A combined retrospective and prospective cohort study was conducted on 64 patients with histologically confirmed BOT, treated surgically between January 2018 and December 2023. Data on clinical presentation, imaging, pathology, treatment modalities, and outcomes were analyzed.
Results: The median age was 46.0 years (range: 16–77), with 59.4% of patients aged <50 years. Serous BOT predominated (78.1%), followed by mucinous (18.7%). Most patients (75.0%) presented at FIGO stage I. Fertility-sparing surgery was performed in 35.9% of cases, and 14.1% underwent laparoscopy. Adjuvant chemotherapy was administered to 20.3% of patients. Over a median follow-up of 33.6 months, two patients (3.1%) experienced recurrence, and one died.
Conclusions: BOT patients at Vietnam National Cancer Hospital are predominantly young, with early-stage serous tumors. The low recurrence rate and limited mortality suggest a favorable prognosis, though fertility-sparing surgery may require vigilant surveillance.
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Keywords
Borderline ovarian tumor; serous; mucinous; fertility-sparing surgery; recurrence
[1]. Hauptmann S, Friedrich K, Redline R, Avril S. Ovarian borderline tumors in the 2014 WHO classification: evolving concepts and diagnostic criteria. Virchows Arch. 2017;470:125–142. https://doi.org/10.1007/s00428-016-2040-8
[2]. Skírnisdóttir I, Garmo H, Wilander E, Holmberg L. Borderline ovarian tumors in Sweden 1960–2005: trends in incidence and age at diagnosis compared to ovarian cancer. Int J Cancer. 2008;123:1897–1901. https://doi.org/10.1002/ijc.23786
[3]. Zanetta G, Rota S, Chiari S, Bonazzi C, Bratina G, Mangioni C. Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol. 2001;19:2658–2664. https://doi.org/10.1200/JCO.2001.19.10.2658
[4]. Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist. 2012;17:1515–1533. https://doi.org/10.1634/theoncologist.2012-0139
[5]. Kipp B, Vidal A, Lenick D, Christmann-Schmid C. Management of borderline ovarian tumors (BOT): results of a retrospective, single-center study in Switzerland. J Ovarian Res. 2023;16:20. https://doi.org/10.1186/s13048-023-01104-4
[6]. Bourdel N, Chabert P, Gremeau AS, et al. Risk factors for recurrence of borderline ovarian tumors in France: a multicenter retrospective study by the FRANCOGYN group. J Gynecol Obstet Hum Reprod. 2020;49:101745. https://doi.org/10.1016/j.jogoh.2020.101745
[7]. du Bois A, Heitz F, Harter P. Clinical management of borderline ovarian tumors: results of a multicentre survey of 323 clinics in Germany. Br J Cancer. 2009;100:1731–1738. https://doi.org/10.1038/sj.bjc.6605066
[8]. Vasconcelos I, de Sousa Mendes M. Conservative surgery in ovarian borderline tumours: a meta-analysis with emphasis on recurrence risk. Eur J Cancer. 2015;51:620–631. https://doi.org/10.1016/j.ejca.2015.01.004
[9]. du Bois A, Ewald-Riegler N, de Gregorio N, et al. Borderline tumours of the ovary: a cohort study of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Study Group. Eur J Cancer. 2013;49:1905–1914. https://doi.org/10.1016/j.ejca.2013.01.035
[10]. Song T, Choi CH, Lee YY, et al. Histologic distribution of borderline ovarian tumors worldwide: a systematic review. J Gynecol Oncol. 2013;24:44–51. https://doi.org/10.3802/jgo.2013.24.1.44
[11]. Rasmussen CB, Kjaer SK, Albieri V, et al. Lifestyle factors and borderline ovarian tumors: a Danish case-control study. Int J Cancer. 2017;140:1310–1319. https://doi.org/10.1002/ijc.30546
[12]. du Bois A, Trillsch F, Mahner S, Heitz F, Harter P. Management of borderline ovarian tumors. Ann Oncol. 2016;27(Suppl 1):i20–i22. https://doi.org/10.1093/annonc/mdw090
[13]. Sutton GP, Bundy BN, Omura GA. Stage III ovarian tumors of low malignant potential treated with cisplatin combination therapy (a Gynecologic Oncology Group study). Gynecol Oncol. 1991;41:230–233. https://doi.org/10.1016/0090-8258(91)90314-U
[14]. Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist. 2012;17:1515–1533. https://doi.org/10.1634/theoncologist.2012-0139
[15]. Kim JH, Cho HJ, Park JH, et al. Diagnostic extended usefulness of RMI: comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors. Arch Gynecol Obstet. 2019;300:1283–1291. https://doi.org/10.1007/s00404-019-05285-7
[16]. Huang K, Li Y, Wang J, et al. A diagnostic system combining inflammation and tumor biomarkers for epithelial ovarian tumors. Front Oncol. 2023;13:1096382. https://doi.org/10.3389/fonc.2023.1096382
[17]. Zheng G, Yu H, Kanerva A, Försti A, Sundquist K, Hemminki K. Borderline ovarian tumors share familial risks with themselves and invasive cancers. Cancer Epidemiol Biomarkers Prev. 2018;27:1358–1363. https://doi.org/10.1158/1055-9965.EPI-18-0503
[18]. Silva EG, Gershenson DM, Malpica A, Deavers M. The recurrence and the overall survival rates of ovarian serous borderline neoplasms with noninvasive implants is time dependent. Am J Surg Pathol. 2006;30:1367–1371. https://doi.org/10.1097/01.pas.0000213299.11649.fa