Annals of Surgical Oncology

, Volume 19, Issue 3, pp 941–947 | Cite as

Behavior of Serous Borderline Ovarian Tumors With and Without Micropapillary Patterns: Results of a French Multicenter Study

  • R. Fauvet
  • E. Demblocque
  • P. Morice
  • D. Querleu
  • E. Daraï
Gynecologic Oncology



Behavior of serous borderline ovarian tumors with micropapillary patterns (MP-SBOT) is thought to be worse than those without micropapillary patterns, but few cohort studies have compared epidemiological characteristics, surgical management, and recurrence rates between these two groups.


In a French retrospective multicenter study of 475 borderline ovarian tumors (BOT) treated from 1990 to 2009, we studied patients with a serous BOT and treated after 2000 including 20 patients with and 77 patients without micropapillary patterns.


Patients with MP-SBOT were younger (P = 0.01), often asymptomatic (P = 0.04), and with abnormal CA 125 serum levels (P = 0.04). Peritoneal implants were more frequently observed in these patients (P = 0.01); also, they underwent conservative treatment more frequently (P = 0.002), had a higher risk of misdiagnosis with invasive carcinoma by intraoperative histology (P < 0.05), and had more frequent restaging surgery (P = 0.001). No difference in recurrence was noted between the groups. No disease-related mortality was observed.


Patients with MP-SBOT represent a heterogeneous population in terms of presence of invasive peritoneal implants. Conservative surgery could be a suitable option for MP-SBOT patients without implants and who wish to conserve childbearing potential, without increasing the risk of recurrence.



The authors thank the participating centers: Centre Hospitalier Universitaire Amiens (Prof. Gondry), Centre Hospitalier Universitaire Angers (Prof. Descamps), Centre de Recherche et de Lutte contre le Cancer Paul Papin Angers (Dr. Fondrinier), Centre Hospitalier Général Le Mans (Dr. Pillot), Centre Hospitalier Universitaire Lille (Prof. Querleu), Centre Hospitalier Universitaire Marseille (Prof. Blanc), Centres Hospitaliers Universitaires Paris: Hôpital Bichat (Prof. Madelenat), Hôpital Cochin (Prof. Chapron), Hôpital de la Pitié-Salpétrière (Prof. Lefranc, Prof. Dommergues), Hôpital Saint Antoine (Prof. Milliez), Hôpital Tenon (Prof. Uzan), Centre Hospitalier Universitaire Reims (Prof. Graesslin), Centre Hospitalier Général Roubaix (Prof. Querleu), Centre Hospitalier Universitaire Rouen (Prof. Marpeau), Institut Gustave Roussy Villejuif (Prof. Morice), and Centre Hospitalier Universitaire Strasbourg (Prof. Baldauf).


  1. 1.
    Scully RE. World Health Organization classification and nomenclature of ovarian cancer. Natl Cancer Inst Monogr. 1975;42:5–7.PubMedGoogle Scholar
  2. 2.
    Classification and staging of malignant tumours in the female pelvis. Acta Obstet Gynecol Scand. 1971;50:1–7.Google Scholar
  3. 3.
    Prat J. Serous tumors of the ovary (borderline tumors and carcinomas) with and without micropapillary features. Int J Gynecol Pathol. 2003;22:25–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Heintz AP, Odicino F, Maisonneuve P, Beller U, Benedet JL, Creasman WT, et al. Carcinoma of the ovary. Int J Gynaecol Obstet. 2003;83 Suppl 1:135–66.PubMedCrossRefGoogle Scholar
  5. 5.
    Burks RT, Sherman ME, Kurman RJ. Micropapillary serous carcinoma of the ovary. A distinctive low-grade carcinoma related to serous borderline tumors. Am J Surg Pathol. 1996;20:1319–30.PubMedCrossRefGoogle Scholar
  6. 6.
    Seidman JD, Kurman RJ. Subclassification of serous borderline tumors of the ovary into benign and malignant types. A clinicopathologic study of 65 advanced stage cases. Am J Surg Pathol. 1996;20:1331–45.PubMedCrossRefGoogle Scholar
  7. 7.
    Seidman JD, Kurman RJ. Ovarian serous borderline tumors: a critical review of the literature with emphasis on prognostic indicators. Hum Pathol. 2000;31:539–57.PubMedCrossRefGoogle Scholar
  8. 8.
    Eichhorn JH, Bell DA, Young RH, Scully RE. Ovarian serous borderline tumors with micropapillary and cribriform patterns: a study of 40 cases and comparison with 44 cases without these patterns. Am J Surg Pathol. 1999;23:397–409.PubMedCrossRefGoogle Scholar
  9. 9.
    Bristow RE, Gossett DR, Shook DR, Zahurak ML, Tomacruz RS, Armstrong DK, et al. Recurrent micropapillary serous ovarian carcinoma. Cancer. 2002;95:791–800.PubMedCrossRefGoogle Scholar
  10. 10.
    Laurent I, Uzan C, Gouy S, Pautier P, Duvillard P, Morice P. Results after conservative treatment of serous borderline tumors of the ovary with a micropapillary pattern. Ann Surg Oncol. 2008;15:3561–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Longacre TA, McKenney JK, Tazelaar HD, Kempson RL, Hendrickson MR. Ovarian serous tumors of low malignant potential (borderline tumors): outcome-based study of 276 patients with long-term (> or =5-year) follow-up. Am J Surg Pathol. 2005;29:707–23.PubMedCrossRefGoogle Scholar
  12. 12.
    Prat J, De Nictolis M. Serous borderline tumors of the ovary: a long-term follow-up study of 137 cases, including 18 with a micropapillary pattern and 20 with microinvasion. Am J Surg Pathol. 2002;26:1111–28.PubMedCrossRefGoogle Scholar
  13. 13.
    Slomovitz BM, Caputo TA, Gretz HF III, Economos K, Tortoriello DV, Schlosshauer PW, et al. A comparative analysis of 57 serous borderline tumors with and without a noninvasive micropapillary component. Am J Surg Pathol. 2002;26:592–600.PubMedCrossRefGoogle Scholar
  14. 14.
    Deavers MT, Gershenson DM, Tortolero-Luna G, Malpica A, Lu KH, Silva EG. Micropapillary and cribriform patterns in ovarian serous tumors of low malignant potential: a study of 99 advanced stage cases. Am J Surg Pathol. 2002;26:1129–41.PubMedCrossRefGoogle Scholar
  15. 15.
    Tavassoli FA, Devilee P. World Health Organization classification of tumors: pathology and genetics of tumors of the breast and female genital organs. Lyon, France: IARC Press; 2003.Google Scholar
  16. 16.
    Seidman JD, Soslow RA, Vang R, Berman JJ, Stoler MH, Sherman ME, et al. Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrated images. Hum Pathol. 2004;35:918–33.PubMedCrossRefGoogle Scholar
  17. 17.
    Chang SJ, Ryu HS, Chang KH, Yoo SC, Yoon JH. Prognostic significance of the micropapillary pattern in patients with serous borderline ovarian tumors. Acta Obstet Gynecol Scand. 2008;87:476–81.PubMedCrossRefGoogle Scholar
  18. 18.
    Acs G. Serous and mucinous borderline (low malignant potential) tumors of the ovary. Am J Clin Pathol. 2005;123 Suppl:S13–57.PubMedGoogle Scholar
  19. 19.
    Bell DA. Origins and molecular pathology of ovarian cancer. Mod Pathol. 2005;18 Suppl 2:S19–32.PubMedCrossRefGoogle Scholar
  20. 20.
    Hogg R, Scurry J, Kim SN, Friedlander M, Hacker N. Microinvasion links ovarian serous borderline tumor and grade 1 invasive carcinoma. Gynecol Oncol. 2007;106:44–51.PubMedCrossRefGoogle Scholar
  21. 21.
    Seidman JD, Kurman RJ. Pathology of ovarian carcinoma. Hematol Oncol Clin North Am. 2003;17:909–925, vii.PubMedCrossRefGoogle Scholar
  22. 22.
    Palomba S, Zupi E, Russo T, Falbo A, Del Negro S, Manguso F, et al. Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: a randomized controlled study. Hum Reprod. 2007;22:578–85.PubMedCrossRefGoogle Scholar
  23. 23.
    Faluyi O, Mackean M, Gourley C, Bryant A, Dickinson HO. Interventions for the treatment of borderline ovarian tumours. Cochrane Database Syst Rev. 2010;CD007696.Google Scholar
  24. 24.
    Brun JL, Cortez A, Rouzier R, Callard P, Bazot M, Uzan S, et al. Factors influencing the use and accuracy of frozen section diagnosis of epithelial ovarian tumors. Am J Obstet Gynecol. 2008;199:244 e241–247.CrossRefGoogle Scholar
  25. 25.
    Fauvet R, Boccara J, Dufournet C, David-Montefiore E, Poncelet C, Darai E. Restaging surgery for women with borderline ovarian tumors: results of a French multicenter study. Cancer. 2004;100:1145–51.PubMedCrossRefGoogle Scholar
  26. 26.
    Rakhshan A, Zham H, Kazempour M. Accuracy of frozen section diagnosis in ovarian masses: experience at a tertiary oncology center. Arch Gynecol Obstet. 2009;280:223–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Medeiros LR, Rosa DD, Edelweiss MI, Stein AT, Bozzetti MC, Zelmanowicz A, et al. Accuracy of frozen-section analysis in the diagnosis of ovarian tumors: a systematic quantitative review. Int J Gynecol Cancer. 2005;15:192–202.PubMedCrossRefGoogle Scholar
  28. 28.
    Poncelet C, Fauvet R, Yazbeck C, Coutant C, Darai E. Impact of serum tumor marker determination on the management of women with borderline ovarian tumors: multivariate analysis of a French multicentre study. Eur J Surg Oncol. 2010;36:1066–72.PubMedCrossRefGoogle Scholar
  29. 29.
    Lin PS, Gershenson DM, Bevers MW, Lucas KR, Burke TW, Silva EG. The current status of surgical staging of ovarian serous borderline tumors. Cancer. 1999;85:905–11.PubMedCrossRefGoogle Scholar
  30. 30.
    Querleu D, Bonnier P, Morice P, Narducci F, Lhomme C, Haie-Meder C, et al. [Initial management of gynecologic cancers: reference guides of the Société Francaise d’Oncologie Gynécologique (SFOG). Gynecol Obstet Fertil. 2008;36:338–52.PubMedCrossRefGoogle Scholar
  31. 31.
    Zapardiel I, Rosenberg P, Peiretti M, Zanagnolo V, Sanguineti F, Aletti G, et al. The role of restaging borderline ovarian tumors: single institution experience and review of the literature. Gynecol Oncol. 2010;119:274–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Querleu D, Papageorgiou T, Lambaudie E, Sonoda Y, Narducci F, Leblanc E. Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours. BJOG. 2003;110:201–4.PubMedCrossRefGoogle Scholar
  33. 33.
    Shih KK, Zhou Q, Huh J, Morgan JC, Iasonos A, Aghajanian C, et al. Risk factors for recurrence of ovarian borderline tumors. Gynecol Oncol. 2011;120:480–4.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • R. Fauvet
    • 1
  • E. Demblocque
    • 1
  • P. Morice
    • 2
  • D. Querleu
    • 3
  • E. Daraï
    • 4
  1. 1.Department of Gynecology and Obstetrics, University Hospital of AmiensUniversity of Picardie, Jules VerneAmiensFrance
  2. 2.Department of Gynecologic Surgery, Gustave Roussy Cancer InstituteUniversity of Paris SudVillejuifFrance
  3. 3.Department of Surgery, Claudius Regaud Cancer InstituteUniversity Paul SabatierToulouseFrance
  4. 4.Department of Gynecology and Obstetrics, Tenon Hospital, AP-HP, Cancer EstUniversity of Paris VIParisFrance

Personalised recommendations