Prognostic Factors and Survival of Borderline Ovarian
Tumors in Rajavithi Hospital between 1979-2006 A.D.
Somboon Sornsukolrat MD*,
Suphet Tuipae MD*
Affiliation :
* Gynecologic Oncology Unit, Department of Obstetrics & Gynecology, Rajavithi Hospital,
College of Medicine, Rangsit University, Bangkok, Thailand
Objective : Evaluate 5-year progression-free survival, 5-year disease-specific survival, and prognostic factors for recurrence
and survival in patients with borderline ovarian tumors in Rajavithi Hospital.
Material and Method: A retrospective study of the patients with borderline ovarian tumors who were treated at Rajavithi
Hospital before 2006 was performed. Patients’ clinical characteristics, detail of treatment and all variables that seemed to
influence survival or recurrence of disease and patients’ life status were obtained from gynecologic oncologic files, medical
record documents, and National Population Statistic Office Database
Results : Two hundred ten patients were enrolled in the present study. Nearly 90% (187 patients, 89%) had stage I disease.
Another seven (3.3%) were in stage II, 15 (7.2%) in stage III, and one (0.5%) in stage IV. The most common histology was
mucinous (157 patients, 74.8%), followed by serous (49 patients, 23.3%) and mixed serous and mucinous (4 patients, 1.9%).
The mean age of the patients was 41 years (range, 14 to 82 years). The mean size of tumor was 17 cm (range, 5 to 40 cm).
The majority of primary treatment was by surgery only at approximately 87.6% (184 patients) and the remaining 12.4%
(26 patients) was surgery plus adjuvant chemotherapy. Bilateral ovarian involvement was found in 13 patients (6.2%).
Twenty-three percent of patients with peritoneal implants had bilateral ovarian involvement whereas the rate in the group
without peritoneal implants was 5.7%. The 5-year progression-free survival (PFS) and 5-year disease-specific interval
(DSS) were 92.32% and 95.72% respectively. Nine patients (4.3%) had recurrence of disease and 11(5.2%) died of disease.
Salvage therapy mainly was surgery and three patients (33%) were cured without evidence of disease. Univariate analysis
showed two significant prognostic factors for PFS. Those were stage of disease and optimal debulking. The four significant
prognostic factors for DSS were stage of disease, optimal debulking, rupture of tumor, and presence of ascites. Conservative
surgery, incomplete staging, lymphadenectomy, periovarian adhesion, or positive peritoneal cytology did not seem to
influence PFS and DSS. Independent prognostic factor for PFS and DSS could not be conclusively drawn by multivariate
analysis because of far too few death and recurrence events in the present study.
Conclusion : The borderline ovarian tumors had an excellent prognosis. Conservative surgery should be carried out in
women at reproductive age with early stage of disease who have fertility desire.
Keywords : Borderline ovarian tumors; Prognostic factors; Recurrence; Survival
All Articles
Download