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What is the impact of stromal microinvasion on oncologic outcomes in borderline ovarian tumors? A multicenter case–control study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate clinicopathological characteristics and oncological outcome of women with microinvasive BOTs.

Methods

A retrospective multicenter case–control study was conducted on 902 patients with BOT, who underwent surgery from January 2002 to December 2015 at six participating gynecologic oncology centers from Turkey. Among 902 patients, 69 had microinvasive BOT. For every patient with microinvasive BOT, two controls were randomly selected from another database based on decade of age and stage of disease at diagnosis. The clinical–pathological characteristics and oncological outcomes were compared between BOT patients with and without stromal microinvasion. Risk factors for poor oncological outcomes were investigated in a multivariate analysis model. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan–Meier method.

Results

Patients with microinvasive BOT had a significantly higher rate of recurrence than patients without microinvasive BOT (17.4 vs 7.8%, OR 3.55, %95 CI 1.091–11.59, p = 0.03). Stage at diagnosis (stage I versus II/III) and type of surgery (cystectomy versus others) were found as other significant prognostic factors for recurrence in multivariate analysis (OR 8.63, %95 CI 2.48–29.9, p = 0.001 and OR 19.4, %95 CI 3.59–105.6, p = 0.001, respectively). Stromal microinvasion was found as a prognostic factor for significantly shorter DFS (26.7 vs 11.9 months, p = 0.031, log rank). However, there was no significant difference in OS between two groups (p = 0.99, log rank).

Conclusion

Stromal microinvasion is significantly associated with decreased DFS. In addition, our study confirms that the risk of recurrence is higher in patients with microinvasive BOT.

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Authors and Affiliations

  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Gokhan Boyraz, Mehmet Coskun Salman, Murat Gultekin, Hasan H. Uckan, Oguzhan Kuru, Anıl Erturk, Nejat Ozgul & Kunter Yuce

  2. Department of Gynecologic Oncology, Zekai Tahir Burak Women’s Health, Education and Research Hospital, Ankara, Turkey

    Nazlı Topfedaisi Ozkan, Mehmet Mutlu Meydanlı & Tayfun Gungor

  3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Gaziler Street, 35120, Izmir, Turkey

    Kemal Gungorduk, Varol Gulseren & Muzaffer Sanci

  4. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Akdeniz University, Antalya, Turkey

    Hulya Ayik, Tayfun Toptas & Tayup Simsek

  5. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Istanbul Faculty of Medicine, Istanbul University, 34390, Istanbul, Turkey

    Hamdullah Sozen & Samet Topuz

  6. Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Etlik St, 06010, Kecioren/Ankara, Turkey

    Taner Turan

Authors
  1. Gokhan Boyraz
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  2. Mehmet Coskun Salman
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  3. Murat Gultekin
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  4. Nazlı Topfedaisi Ozkan
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  5. Hasan H. Uckan
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  6. Kemal Gungorduk
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  7. Varol Gulseren
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  8. Hulya Ayik
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  9. Tayfun Toptas
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  10. Oguzhan Kuru
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  11. Hamdullah Sozen
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  12. Anıl Erturk
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  13. Nejat Ozgul
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  14. Mehmet Mutlu Meydanlı
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  15. Muzaffer Sanci
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  16. Taner Turan
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  17. Tayfun Gungor
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  18. Tayup Simsek
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  19. Samet Topuz
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  20. Kunter Yuce
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Contributions

GB: project development, data collection, and manuscript writing; MCS: project development, data management, and manuscript writing; MG: manuscript writing, manuscript editing; NTO: data collection, and manuscript writing; HU: data collection; KG: manuscript writing and manuscript editing; VG: data collection; HA: data collection; TT: manuscript writing and data management; OK: manuscript writing and data management; HS: manuscript writing and data management; AE: data collection; NO: project development, data management, and manuscript writing; MMM: project development, data management, and manuscript writing; MS: manuscript writing and manuscript editing; TT: manuscript writing and manuscript editing; TG: manuscript writing and manuscript editing; TS: project development, data collection, and manuscript writing; ST: manuscript writing and manuscript editing; KY: project development, data collection, and manuscript writing

Corresponding author

Correspondence to Gokhan Boyraz.

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Conflict of interest

There are no potential conflicts of interest to declare and no relevant sources of funding for this study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Boyraz, G., Salman, M.C., Gultekin, M. et al. What is the impact of stromal microinvasion on oncologic outcomes in borderline ovarian tumors? A multicenter case–control study. Arch Gynecol Obstet 296, 979–987 (2017). https://doi.org/10.1007/s00404-017-4496-4

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  • DOI: https://doi.org/10.1007/s00404-017-4496-4

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