[Clinicopathologic analysis of 130 cases of mucinous borderline ovarian tumors].

ABSTRACT

OBJECTIVE: To determine the clinicopathologic characteristics of mucinous borderline ovarian tumors (MBOT) and evaluate the risk factors for recurrence. METHODS: A retrospective study included age, the level of preoperative serum CA125, surgical procedures, surgical-staging and the risk factors for recurrence in 130 patients with MBOT who were treated from Jan. 1994 to Dec. 2008 in Peking Union Medical College Hospital was done. RESULTS: Preoperative serum CA125 and CA199 were elevated in 34% (33/96) and 50% (13/26) of patients respectively. Fifty-two radical surgeries included total hysterectomy and bilateral salpingo-ovarectomy (THBSO) and 78 fertility-sparing surgeries included 54 salpingo-oovarectomies (SO) and 24 cystectomy were done. Fifty-five cases underwent comprehensive surgical staging. Mean size of the tumors was (16 ± 10) cm and 90.0% (117/130) were limited to unilateral ovary. There were 59 (45.4%) cases, 62 (47.7%) cases, 2 (1.5%) cases and 7 (5.4%) cases in stage Ia, Ic, II, III, respectively. Forty-five (34.6%) concurrent with benign mucinous tumors, 14 (10.8%) ovarian intraepithelial carcinoma, 8 (6.2%) micro-invasive carcinoma and 4 (3.1%) pseudomyxoma peritonei were found. Median duration for follow-up was 56.3 months. Sixteen (12.3%) recurrences and 2 tumor related deaths were found. Median duration from surgery to recurrence was 25.6 months. Recurrent rate after THBSO (4%, 2/49) was significantly lower than that of SO (13%, 7/54) and cystectomy (17%, 4/24; P < 0.05). The recurrent rate of Ic or III was 18% (11/62) or 3/7, which were significantly higher than that of stage Ia (3%, 2/59; P < 0.05). Three of the 4 pseudomyxoma peritonei appeared of recurrence. While, the results showed that these were no effect on recurrent rate whether concurrent intraepithelial, microinvasive carcinoma or not comprehensive staging surgery. CONCLUSIONS: Majority of MBOT were diagnosed in early stage and have favorable prognosis. Patients who take conservative surgery had higher recurrence rate than those radical surgery, but it doesn't affect survival. Late stage and concurrent pseudomyxoma peritonei are risk factors for recurrence.