Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic restaging of borderline ovarian tumors

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

This study aimed to evaluate the feasibility and relevance of laparoscopic restaging surgery for women with borderline ovarian tumors.

Methods

From March 2001 to February 2006, 42 women referred for borderline ovarian tumors after laparoscopy or laparotomy underwent a laparoscopic restaging operation. Of these women, 37 (88%) had undergone conservative surgery including unilateral cystectomy (n = 16), bilateral cystectomy (n = 1), and unilateral salpingo-oophorectomy (n = 20). The remaining five women (12%) had undergone radical surgery, including bilateral salpingo-oophorectomy (BSO) (n = 4) and hysterectomy with BSO (n = 1). Intraoperative rupture occurred in 13 cases.

Results

All 42 restaging operations were performed via the laparoscopic approach. There were no intraoperative complications, no laparoconversions, and no postoperative complications. Laparoscopic restaging identified two persistent borderline ovarian tumors (12%) in women who had initially undergone cystectomy. Seven women were upstaged (16.6%) because of positive cytology (n = 2), peritoneal biopsy (n = 2), or omentum (n = 3). Among the 28 women with initial Federation International of Gynaecology and Obstetrics (FIGO) stage Ia disease, the final stage was Ia for 24 women, Ib for 2 women, IIIa for 1 woman, and IIIc for 1 woman. Among the 12 women with initial stage Ic disease, 11 kept the same stage and 1 was upstaged to IIIc. The woman with initial stage IIa disease was upstaged to IIb, and the woman with initial stage IIc disease was upstaged to IIIc. The risk of upstaging was significantly higher among women with serous borderline tumors. Upstaging occurred in women with both initial stages I and II disease.

Conclusions

The results confirm the feasibility and safety of laparoscopic restaging operations for women with borderline ovarian tumors. Cystectomy was associated with a risk of persistent lesions. The risk of upstaging was higher for women with serous borderline ovarian tumors and women with initial FIGO stage I or II disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Trimble EL, Trimble LC (1993) Epithelial ovarian tumors of low malignant potential. In: Markman M, Hoskins WJ (eds) Cancer of the ovary. Raven Press, New York pp 415–429

    Google Scholar 

  2. Hoskins P (1995) Ovarian tumors of low malignant potential: borderline epithelial ovarian carcinoma. BMJ Publishing Group, London

    Google Scholar 

  3. Pinto PB, Andrade LA, Derchain SF (2001) Accuracy of intraoperative frozen section diagnosis of ovarian tumors. Gynecol Oncol 81: 230–232

    Article  PubMed  CAS  Google Scholar 

  4. Ilvan S, Ramazanoglu R, Ulker Akyildiz E, Calay Z, Bese T, Oruc N (2005) The accuracy of frozen section (intraoperative consultation) in the diagnosis of ovarian masses. Gynecol Oncol 97: 395–399

    Article  PubMed  Google Scholar 

  5. Geomini P, Bremer G, Kruitwagen R, Mol BW (2005) Diagnostic accuracy of frozen section diagnosis of the adnexal mass: a metaanalysis. Gynecol Oncol 96: 1–9

    Article  PubMed  Google Scholar 

  6. International Federation of Gynaecoloy and Obstetrics (1989) Annual report and results of treatment in gynaecologic cancer. Int J Gynaecol Obstet 28: 189–190

    Article  Google Scholar 

  7. Bostwick DG, Tazelaar HD, Ballon SC, Hendrickson MR, Kempson RL (1986) Ovarian epithelial tumors of borderline malignancy: a clinical and pathologic study of 109 cases. Cancer 58: 2052–2065

    Article  PubMed  CAS  Google Scholar 

  8. Lim-Tan SK, Cajigas HE, Scully RE (1988) Ovarian cystectomy for serous borderline tumors: a follow-up study of 35 cases. Obstet Gynecol 72: 775–781

    PubMed  CAS  Google Scholar 

  9. Darai E, Teboul J, Fauconnier A, Scoazec JY, Benifla JL, Madelenat P (1998) Management and outcome of borderline ovarian tumors incidentally discovered at or after laparoscopy. Acta Obstet Gynecol Scand 77: 451–457

    Article  PubMed  CAS  Google Scholar 

  10. Seracchioli R, Venturoli S, Colombo FM, Govoni F, Missiroli S, Bagnoli A (2001) Fertility and tumor recurrence rate after conservative laparoscopic management of young women with early-stage borderline ovarian tumors. Fertil Steril 76: 999–1004

    Article  PubMed  CAS  Google Scholar 

  11. Zanetta G, Rota S, Chiari S, Bonazzi C, Bratina G, Mangioni C (2001) Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol 19: 2658–2664

    PubMed  CAS  Google Scholar 

  12. Morice P, Camatte S, Wicart-Poque F, Atallah D, Rouzier R, Pautier P, Pomel C, Lhomme C, Duvillard P, Castaigne D (2003) Results of conservative management of epithelial malignant and borderline ovarian tumors. Hum Reprod Update 9: 185–192

    Article  PubMed  Google Scholar 

  13. Tinelli R, Tinelli A, Tinelli FG, Cicinelli E, Malvasi A (2006) Conservative surgery for borderline ovarian tumors: a review. Gynecol Oncol 100: 185–191

    Article  PubMed  Google Scholar 

  14. Barnhill DR, Kurman RJ, Brady MF, Omura GA, Yordan E, Given FT, Kucera PR, Roman LD (1995) Preliminary analysis of the behavior of stage I ovarian serous tumors of low malignant potential: a Gynecologic Oncology Group study. J Clin Oncol 13: 2752–2756

    PubMed  CAS  Google Scholar 

  15. Trope CG, Kristensen G, Makar A (2000) Surgery for borderline tumor of the ovary. Semin Surg Oncol 19: 69–75

    Article  PubMed  CAS  Google Scholar 

  16. Gershenson DM (1999) Contemporary treatment of borderline ovarian tumors. Cancer Invest 17: 206–210

    Article  PubMed  CAS  Google Scholar 

  17. Riopel MA, Ronnett BM, Kurman RJ (1999) Evaluation of diagnostic criteria and behavior of ovarian intestinal-type mucinous tumors: atypical proliferative (borderline) tumors and intraepithelial, microinvasive, invasive, and metastatic carcinomas. Am J Surg Pathol 23: 617–635

    Article  PubMed  CAS  Google Scholar 

  18. Kurman RJ, Seidman JD (2000) Ovarian serous borderline tumors: the citadel defended. Hum Pathol 31: 1439–1442

    Article  PubMed  CAS  Google Scholar 

  19. Poncelet C, Fauvet R, Boccara J, Darai E (2006) Recurrence after cystectomy for borderline ovarian tumors: results of a French multicenter study. Ann Surg Oncol 13: 565–571

    Article  PubMed  Google Scholar 

  20. Winter WE, Kucera PR, Rodgers W, McBroom JW, Olsen C, Maxwell GL (2002) Surgical staging in patients with ovarian tumors of low malignant potential. Obstet Gynecol 671–676

  21. Yazigi R, Sandstad J, Munoz AK (1988) Primary staging in ovarian tumors of low malignant potential. Gynecol Oncol 31: 402–408

    Article  PubMed  CAS  Google Scholar 

  22. Hopkins MP, Morley GW (1989) The second-look operation and surgical reexploration in ovarian tumor of low malignant potential. Obstet Gynecol 74: 375–378

    PubMed  CAS  Google Scholar 

  23. Snider DD, Stuart GC, Nation JG, Robertson DI (1991) Evaluation of surgical staging in stage I low malignant potential ovarian tumors. Gynecol Oncol 40: 129–132

    Article  PubMed  CAS  Google Scholar 

  24. Lin PS, Gershenson DM, Bevers MW, Lucas KR, Burke TW, Silva EG (1999) The current status of surgical staging of ovarian serous borderline tumors. Cancer 85: 905–911

    Article  PubMed  CAS  Google Scholar 

  25. Fauvet R, Boccara J, Dufournet C, David-Montefiore E, Poncelet C, Darai E (2004) Restaging surgery for women with borderline ovarian tumors: results of a French multicenter study. Cancer 100: 1145–1151

    Article  PubMed  Google Scholar 

  26. Querleu D, Papageorgiou T, Lambaudie E, Sonoda Y, Narducci F, LeBlanc E (2003) Laparoscopic restaging of borderline ovarian tumors: results of 30 cases initially presumed as stage IA borderline ovarian tumors. Br J Obstet Gynaecol 110: 201–204

    CAS  Google Scholar 

  27. Canis M, Mage G, Pouly JL, Wattiez A, Manhes H, Bruhat MA (1994) Laparoscopic diagnosis of adnexal cystic masses: a 12-year experience with long-term follow-up. Obstet Gynecol 83: 707–712

    PubMed  CAS  Google Scholar 

  28. Maneo A, Vignali M, Chiari S, Colombo A, Mangioni C, Landoni F (2004) Are borderline tumors of the ovary safely treated by laparoscopy? Gynecol Oncol 94: 387–392

    Article  PubMed  Google Scholar 

  29. Fauvet R, Boccara J, Dufournet C, Poncelet C, Darai E (2005) Laparoscopic management of borderline ovarian tumors: results of a French multicenter study. Ann Oncol 16: 403–410

    Article  PubMed  CAS  Google Scholar 

  30. Bazot M, Nassar-Slaba J, Thomassin-Naggara I, Cortez A, Uzan S, Darai E (2006) MR imaging compared with intraoperative frozen-section examination for the diagnosis of adnexal tumors: correlation with final histology. Eur Radiol 16: 2687–2699

    Article  PubMed  Google Scholar 

  31. Lim-Tan SK, Cajigas HE, Scully RE (1988) Ovarian cystectomy for serous borderline tumors: a follow-up study of 35 cases. Obstet Gynecol 72: 775–781

    PubMed  CAS  Google Scholar 

  32. Morice P (2006) Borderline tumors of the ovary and fertility. Eur J Cancer 42: 149–158

    Article  PubMed  CAS  Google Scholar 

  33. Ayhan A, Guvendag E, Guven S, Kucukali T (2005) Recurrence and prognostic factors in borderline ovarian tumors. Gynecol Oncol 98: 439–445

    Article  PubMed  Google Scholar 

  34. Longacre TA, McKenney JK, Tazelaar HD, Kempson RL, Hendrickson MR (2006) Ovarian serous tumors of low malignant potential (borderline tumors): outcome-based study of 276 patients with long-term (≥5-year) follow-up. Am J Surg Pathol 29: 707–723

    Google Scholar 

  35. Seidman JD, Kurman RJ (2000) Ovarian serous borderline tumors: a critical review of the literature with emphasis on prognostic indicators. Hum Pathol 31: 539–557

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France

    E. Daraï, L. Tulpin, H. Prugnolle & G. Dubernard

  2. AP-HP, CancerEst, Université Pierre et Marie Curie, Paris 6, France

    A. Cortez

Authors
  1. E. Daraï
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Tulpin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Prugnolle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Cortez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Dubernard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Daraï.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Daraï, E., Tulpin, L., Prugnolle, H. et al. Laparoscopic restaging of borderline ovarian tumors. Surg Endosc 21, 2039–2043 (2007). https://doi.org/10.1007/s00464-007-9286-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-007-9286-9

Keywords

Search

Navigation