Clinicopathological parameters and survival of invasive epithelial ovarian cancer by histotype and disease stage.

Aim: To investigate clinicopathological parameters and histotype-specific survival of epithelial ovarian cancer by stage using the 2014 WHO classification. Patients & methods: Patients were obtained from the SEER database. Multivariate and univariate Cox regression analyses were applied to assess survival outcomes. Results: Irrespective of stages, low-grade serous and endometrioid had the best survival rates. In localized and regional stages, the poorest survival rates were detected for carcinosarcoma and malignant Brenner tumors, but in distant stage, the worst prognoses were observed in mucinous, clear cell and carcinosarcoma (p < 0.05 for all). Conclusion: Our study displayed significant differences in clinicopathological parameters and histotype-specific survival by stages that reflected current consensus on histotype classification and pathogenesis of epithelial ovarian cancer.

Malignant Brenner tumors of the ovary; a population-based analysis.

OBJECTIVE: Malignant Brenner Tumor (MBT) is a tumor with an extremely low incidence that morphologically resembles to urothelium. Given the paucity of evidence on the epidemiology and prognosis of MBT, the aim of this retrospective population-based study was to elucidate the demographic and clinico-pathological characteristics of patients with ovarian MBT. METHODS: A cohort of patients diagnosed between 1988 and 2012 was drawn from the National Cancer Institute Surveillance and Epidemiology End Results database. For surgically treated patients, Observed and Disease Specific Survival were calculated following generation of Kaplan-Meier curves. Comparisons were made using the log-rank test. RESULTS: A total of 207 patients were identified. Median patient age was 65years and the majority presented with unilateral, high grade tumors with a median size of 10cm. Stage I, II, III and IV disease was noted for 55.4%, 14.4%, 18%, and 12.2% of patients respectively. Only 5.1% had positive lymph nodes for metastatic disease. Five-year disease-specific survival (DSS) of patients with tumors confined to the ovary was 94.5% compared to 51.3% for those with extra-ovarian spread (p<0.001). Lymphadenectomy was not associated with an improved DSS (p=0.2). CONCLUSIONS: MBTs are typically unilateral high grade tumors localized to the ovary. Regional lymphatic spread is uncommon and lymphadenectomy does not confer any improvement on survival. Patients with tumors confined to the ovary have an excellent prognosis while extra-ovarian spread is associated with a poor outcome.

Intensive systemic chemotherapy is effective against recurrent malignant Brenner tumor of the ovary: An analysis of 10 cases within a single center.

OBJECTIVE: Malignant Brenner tumors (MBTs) of the ovary are very rare, and their definition, biology, and treatment modality have not been established. This study investigated the clinical characteristics of MBTs and the importance of chemotherapy for recurrent disease. MATERIALS AND METHODS: We conducted a retrospective analysis of 10 patients with MBT of the ovary treated at a single tertiary center from 1991 to 2013. RESULTS: The median age was 55.5 years (range, 37-68 years). Nine of the 10 patients were symptomatic. The median size of the ovarian tumors was 10.5 cm (range, 2.5-25.0 cm). The cancer antigen-125 level was elevated in three patients. Six patients had a stage I tumor, one had a stage II tumor, two had a stage III tumor, and one had a stage IV tumor. Six patients received systemic adjuvant chemotherapy after surgery. The mean follow-up duration was 54.5 months (range, 8-173 months). Disease recurrence occurred in four of the 10 patients. The median time to recurrence was 11 months (range, 9-18 months). Two patients with locoregional recurrence showed favorable results after chemotherapy, regardless of the initial stage of the tumor. The patient with the stage IIIC tumor is alive at 13 months after recurrence on current chemotherapy. The patient with the stage IV tumor showed no evidence of the disease > 12 years after the last chemotherapy. Lastly, two patients with distant recurrence died after showing a long-term survival of 49 months and 88 months, respectively, after recurrence and intensive chemotherapy. CONCLUSION: Our results showed that systemic chemotherapy is beneficial in patients with recurrence of a primary MBT of the ovary, especially in the locoregional recurrence.

Thrombospondin-1 and -2 messenger RNA expression in epithelial ovarian tumor.

BACKGROUND: The role of thrombospondin (TSP) in tumor progression remains controversial. The association of TSP with clinicopathological features regarding prognostic significance was examined in patients with epithelial ovarian tumor. MATERIALS AND METHODS: Gene expression of TSP-1 and TSP-2 was assessed by reverse transcriptase-polymerase chain reaction in 6 borderline and 29 malignant epithelial ovarian tumors. RESULTS: TSP-1 mRNA expression was detected in 14 out of the 29 malignant epithelial ovarian tumors (48.3%), whereas TSP-2 mRNA expression was detected in 7 malignant epithelial ovarian tumors (24.1%). In contrast, no specimen from the borderline epithelial ovarian tumors expressed TSP mRNA. TSP-1 expression was significantly higher in tumors with advanced stage, massive ascites, positive peritoneal cytology and high grade. TSP-2 expression was significantly higher in tumors with massive ascites. Patients exhibiting TSP-1 and -2 mRNA expression demonstrated a markedly poorer prognosis than those lacking TSP-1 and -2 mRNA expression. CONCLUSION: These findings provide evidence that TSP expression may be associated with an aggressive phenotype in this class of neoplasm.

Ovarian Brenner tumors and transitional cell carcinoma: recent developments.

Brenner tumor variants--such as metaplastic, proliferating, and low-malignant-potential (three categories recently designated as intermediate Brenner tumors)--and malignant Brenner tumors are unusual tumors presenting problems in classification. DNA ploidy and S-phase reflect the intermediate status of metaplastic, proliferating, and low-malignant-potential Brenner tumors. The category of "transitional cell carcinoma of the ovary" has been proposed for those primary ovarian carcinomas in which definite urothelial features are present, but no benign, metaplastic, and/or proliferating Brenner tumor is identified. Two subtypes have been described, the papillary and the malignant Brenner-like types. These tumors are more aggressive than malignant Brenner tumors, but they appear to respond better to chemotherapy than other types of ovarian epithelial cancer.

[Clinico-pathological study of elderly women with malignant ovarian tumors].

Twenty-five elderly women (those 70 years or older) with borderline and malignant ovarian tumors during the past 20 years were reviewed clinico-pathologically in comparison with 160 younger women (those 69 years or younger). The following results were obtained: 1) The incidence rate of elderly women for all patients of borderline and malignant ovarian tumors was 13.5%, and did not tend to increase in the past several years. 2) The rate that the elderly woman visited first at the other department excepting the department of obstetrics and gynecology was 36%, and which was statistically higher than that of the younger woman (p less than 0.01). 3) Fifty-two % of elderly patients had some complications and the incidence was significantly higher than that (23.1%) of younger patients (p less than 0.005). 4) Histopathologically in elderly patients, 9 patients (36%) were of serous cystadenocarcinoma and 17 patients (68%) were of malignant epithelial tumor (primary ovarian cancer and malignant Brenner tumor). 5) Of elderly patients, 8 (47.1%) were in Stage III and IV, and it was higher incidence than that (33.3%) of younger patients. In advanced cases, the histological grades became more poorly. 6) The survival rate of elderly patients in Stage III and IV was significantly lower than that in Stage I and II. The various treatment for Stage III and IV patients did not demonstrate the correlation in prognosis. In contrast, the survival rate for the group treated surgically in Stage I and II was significantly higher than that of non-surgical group (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Malignant Brenner tumor and transitional cell carcinoma of the ovary: a comparison.

The clinical and pathologic features of 16 malignant Brenner tumors (MBT) having an associated benign Brenner component were compared with 29 primary ovarian transitional cell carcinomas (TCC), neoplasms differing from MBT only in that a benign Brenner component was absent. Transitional cell carcinoma represented a more aggressive neoplasm. Twenty of twenty-nine (69%) presented in advanced stages (II-IV) compared with only three of sixteen (19%) MBT. Among stage IA tumors, only three of seven (43%) patients with TCC were well at last contact, compared with nine of eleven (88%) patients with Stage IA MBT. In addition to not having a benign Brenner component, TCC lacked the prominent stromal calcification common in most benign and malignant Brenner tumors. Transitional cell carcinoma is sufficiently different from MBT in that it is reasonable to suppose that ovarian TCC arises directly from pluripotential surface epithelium of the ovary and from cells with urothelial potential, rather than from a benign or proliferative Brenner tumor precursor.