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Is There Re-staging Surgery Necessity for Borderline Ovarian Tumors

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Abstract

Objective

This study assessed the necessity of surgical re-staging in women with borderline ovarian tumors (BOTs) and evaluated the impact of complete surgical staging, lymphadenectomy, and omentectomy on disease recurrence and survival.

Methods

We retrospectively reviewed the medical records of patients with BOTs. A total of 901 patients were eligible for inclusion in the study, and we evaluated some of the variables and clinical/surgical characteristics of the cases. The effects of the type of surgical procedure, surgical staging, and complete or incomplete staging on recurrence were calculated. The rates of disease-free survival, overall survival, and recurrence were compared according to complete surgical staging. A Cox regression analysis was performed to identify potential prognostic factors, and survival curves were constructed using the Kaplan-Meier method.

Results

The overall recurrence rate was 13.9%, and recurrence was comparable between the complete surgical staging group and the incomplete groups (P>0.05). The performance of complete surgical staging did not show an effect on long-term survival, and complete surgical staging, omentectomy, and lymphadenectomy had no effect on recurrence. In multivariate analyses, only radical surgery and adjuvant chemotherapy were risk factors for the recurrence of BOTs. Furthermore, we found that omentectomy led to a relatively low recurrence rate in patients with International Federation of Gynecology and Obstetrics (FIGO) stage > I (P=0.022).

Conclusion

Our results suggest that complete surgical staging should be considered a standard treatment for patients with advanced stage BOTs but not for those at FIGO stage I. It might be safe to reduce the scope of surgical procedures in patients with early-stage BOTs. However, it is not necessary to perform re-staging operations for BOTs with a macroscopically normal extra-ovarian appearance.

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References

  1. Colombo N, Sessa C, du Bois A, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann Oncol, 2019,30(5):672–705

    Article  CAS  PubMed  Google Scholar 

  2. Bourdel N, Huchon C, Abdel Wahab C, et al. Borderline ovarian tumors: Guidelines from the French national college of obstetricians and gynecologists (CNGOF). Eur J Obstet Gynecol Reprod Biol, 2021,256:492–501

    Article  CAS  PubMed  Google Scholar 

  3. Plett H, Harter P, Ataseven B, et al. Fertility-sparing surgery and reproductive-outcomes in patients with borderline ovarian tumors. Gynecol Oncol, 2020,157(2):411–417

    Article  PubMed  Google Scholar 

  4. Morice P, Uzan C, Fauvet R, et al. Borderline ovarian tumour: pathological diagnostic dilemma and risk factors for invasive or lethal recurrence. Lancet Oncol, 2012,13(3):e103–e115

    Article  PubMed  Google Scholar 

  5. De Decker K, Jaroch KH, Bart J, et al. Borderline ovarian tumor frozen section diagnoses with features suspicious of invasive cancer: a retrospective study. J Ovarian Res, 2021,14(1):139

    Article  PubMed  PubMed Central  Google Scholar 

  6. Yoshida H, Tanaka H, Tsukada T, et al. Diagnostic Discordance in Intraoperative Frozen Section Diagnosis of Ovarian Tumors: A Literature Review and Analysis of 871 Cases Treated at a Japanese Cancer Center. Int J Surg Pathol, 2021,29(1):30–38

    Article  PubMed  Google Scholar 

  7. Laban M, Chen X, Guo B. Seromucinous and Mucinous Borderline Ovarian Tumors: We Need to Know More. Reprod Sci, 2022,30(5):1684–1685

    Article  PubMed  Google Scholar 

  8. Matsuo K, Machida H, Mandelbaum RS, et al. Mucinous borderline ovarian tumor versus invasive well-differentiated mucinous ovarian cancer: Difference in characteristics and outcomes. Gynecol Oncol, 2019,153(2):230–237

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chevrot A, Pouget N, Bats AS, et al. Fertility and prognosis of borderline ovarian tumor after conservative management: Results of the multicentric OPTIBOT study by the GINECO & TMRG group. Gynecol Oncol, 2020,157(1):29–35

    Article  PubMed  Google Scholar 

  10. Chevrot A, Héquet D, Fauconnier A, et al. Impact of surgical restaging on recurrence in patients with borderline ovarian tumors: A meta-analysis. Eur J Obstet Gynecol Reprod Biol, 2020,248:227–232

    Article  CAS  PubMed  Google Scholar 

  11. May J, Skorupskaite K, Congiu M, et al. Borderline Ovarian Tumors: Fifteen Years’ Experience at a Scottish Tertiary Cancer Center. Int J Gynecol Cancer, 2018,28(9):1683–1691

    Article  PubMed  Google Scholar 

  12. Jung HJ, Park JY, Kim DY, et al. Low value of staging in detecting extraovarian occult metastasis in mucinous borderline ovarian tumors. Int J Gynecol Cancer, 2020,30(11):1780–1783

    Article  PubMed  Google Scholar 

  13. Chevrot A, Héquet D, Fauconnier A, et al. Impact of surgical restaging on recurrence in patients with borderline ovarian tumors: A meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2020,248:227–232

    Article  CAS  PubMed  Google Scholar 

  14. Abdallah R, Chamsy D, Dagher C, et al. Borderline ovarian tumors: a retrospective cohort study on single institution experience, practice patterns and outcomes. J Obstet Gynaecol, 2022,42(8):3600–3604

    Article  PubMed  Google Scholar 

  15. Shim SH, Kim SN, Jung PS, et al. Impact of surgical staging on prognosis in patients with borderline ovarian tumours: A meta-analysis. Eur J Cancer, 2016,54:84–95

    Article  PubMed  Google Scholar 

  16. Bendifallah S, Nikpayam M, Ballester M, et al. New Pointers for Surgical Staging of Borderline Ovarian Tumors. Ann Surg Oncol, 2016,23(2):443–449

    Article  PubMed  Google Scholar 

  17. Guvenal T, Dursun P, Hasdemir PS, et al. Effect of surgical staging on 539 patients with borderline ovarian tumors: a Turkish Gynecologic Oncology Group study. Gynecol Oncol, 2013,131(3):546–550

    Article  PubMed  Google Scholar 

  18. Gokcu M, Gungorduk K, Aşıcıoğlu O, et al. Borderline ovarian tumors: clinical characteristics, management, and outcomes - a multicenter study. J Ovarian Res, 2016,9(1):66

    Article  PubMed  PubMed Central  Google Scholar 

  19. Trillsch F, Mahner S, Vettorazzi E, et al. Surgical staging and prognosis in serous borderline ovarian tumours (BOT): a subanalysis of the AGO ROBOT study. Br J Cancer, 2015,112(4):660–666

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Romeo M, Pons F, Barretina P, et al. Incomplete staging surgery as a major predictor of relapse of borderline ovarian tumor. World J Surg Oncol, 2013,11:13

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lee JY, Kim HS, Chung HH, et al. The role of omentectomy and random peritoneal biopsies as part of comprehensive surgical staging in apparent early-stage epithelial ovarian cancer. Ann Surg Oncol, 2014,21(8):2762–2766

    Article  PubMed  Google Scholar 

  22. De Decker K, Speth S, Ter Brugge HG, et al. Staging procedures in patients with mucinous borderline tumors of the ovary do not reveal peritoneal or omental disease. Gynecol Oncol, 2017,144(2):285–289

    Article  PubMed  Google Scholar 

  23. Matsuo K, Machida H, Grubbs BH, et al. Diagnosis-shift between low-grade serous ovarian cancer and serous borderline ovarian tumor: A population-based study. Gynecol Oncol, 2020,157(1):21–28

    Article  PubMed  PubMed Central  Google Scholar 

  24. Qian XQ, Hua XP, Wu JH, et al. Clinical Predictors of Recurrence and Prognostic Value of Lymph Node Involvement in the Serous Borderline Ovarian Tumor. Int J Gynecol Cancer, 2018,28(2):279–284

    Article  PubMed  Google Scholar 

  25. Fan Y, Zhang YF, Wang MY, et al. Influence of lymph node involvement or lymphadenectomy on prognosis of patients with borderline ovarian tumors: A systematic review and meta-analysis. Gynecol Oncol, 2021,162(3):797–803

    Article  PubMed  Google Scholar 

  26. Nusbaum DJ, Mandelbaum RS, Machida H, et al. Significance of lymph node ratio on survival of women with borderline ovarian tumors. Arch Gynecol Obstet, 2020,301(5):1289–1298

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kristensen GS, Schledermana D, Mogensen O, et al. The value of random biopsies, omentectomy, and hysterectomy in operations for borderline ovarian tumors. Int J Gynecol, 2014,24(5):874–879

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Li-li Guo, Xiao-yan Kang, Yue Su, Xiao-yu Liu, Xue Wu, Wan Xie, Yu-huan Liu & Chang-yu Wang

Authors
  1. Li-li Guo
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  2. Xiao-yan Kang
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  3. Yue Su
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  4. Xiao-yu Liu
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  5. Xue Wu
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  6. Wan Xie
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  7. Yu-huan Liu
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  8. Chang-yu Wang
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Corresponding author

Correspondence to Chang-yu Wang.

Ethics declarations

We declare that we have no financial or personal relationships with other people or organizations that could inappropriately influence our work. All authors declare that they have no conflict of interest.

Additional information

This study was funded by the National Natural Science Foundation of China (No. 81802612).

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Guo, Ll., Kang, Xy., Su, Y. et al. Is There Re-staging Surgery Necessity for Borderline Ovarian Tumors. CURR MED SCI 43, 822–830 (2023). https://doi.org/10.1007/s11596-023-2775-9

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  • DOI: https://doi.org/10.1007/s11596-023-2775-9

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