Serous borderline tumor with micropapillary pattern of the right ovary that developed 6 recurrences over 30 years after primary surgery.

Serous borderline tumors (SBTs) are nonaggressive and have excellent prognosis. Furthermore, SBTs with micropapillary pattern (SBT-MP) are known to be associated with a higher recurrence rate, microinvasions and invasive implants compared to typical SBTs, and these characteristics have adverse effects on prognosis. Here, we report a case of SBT with micropapillary pattern (SBT-MP) that developed 6 recurrences over 30 years after primary surgery. The patient was a 70 year-old woman. At 41 years of the age she underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy and pelvic lymphadenectomy and was found to have an SBT-MP involving the right ovary (International Federation of Gynecology and Obstetrics 2014, stage IC2). She was administered chemotherapy (cyclophosphamide, adriamicin, and cisplatin). She repeatedly developed recurrences 6 times after primary surgery. A left inguinal recurrence at age 55, a right inguinal recurrence at age 56, a right inguinal recurrence at age 64, an umbilical recurrence at age 65, a right inguinal recurrence at age 68 and left axillary recurrence at age 70. Histopathological examinations revealed that all recurrences were SBT-MP with noninvasive implants. Our case strongly justifies the belief that recurrent SBTs carry an excellent prognosis unless they develop significant malignant transformation.

A feasibility study on maintenance of docetaxel after paclitaxel-carboplatin chemotherapy in patients with advanced ovarian cancer.

OBJECTIVE: To test the concept of taxane sequencing, this feasibility trial evaluated maintenance of docetaxel after paclitaxel and carboplatin combination chemotherapy in patients with stage IC-IV ovarian cancer. METHODS: All patients received debulking surgery followed by paclitaxel and carboplatin chemotherapy. Attainment of clinically defined complete or partial response was confirmed by image scanning. Maintenance of docetaxel started at an initial dose of 70 mg/m(2) every 4 weeks for 6 cycles and was extended to 10 cycles unless disease progression and/or recurrence during the protocol therapy or unacceptable toxicities were seen. RESULTS: Stage subsets in 20 eligible patients were as follows: IIIB, 2 patients (10%); IIIC, 13 patients (65%); IV, 5 patients (25%). Neutropenia was common (40% with grade 3 or 4) and was most frequent during first or second cycle although the disabling peripheral neuropathy was not observed. Twelve patients completed protocol therapy (6≤cycles), while 8 patients failed to complete 6-cycle chemotherapy, because of progressive disease (5 patients) or grade 4 toxicities (3 patients). Median PFS was 20 months and 3-year PFS rate was 12%. Median overall survival was 39 months and 3-year OS rate was 69%. CONCLUSION: Six cycles of single-agent docetaxel maintenance chemotherapy is feasible and generally tolerable to women with advanced ovarian cancer who attained a clinically defined response to initial paclitaxel and carboplatin based chemotherapy.