Risk factors for recurrence of ovarian borderline tumors

ObjectiveThe objective of this study was to identify clinicopathologic features that are associated with an increased risk of recurrence for borderline ovarian tumors (BOT).MethodsWe performed a retrospective review of all patients treated for BOT at our institution from 1979 to 2008. Progression-free survival (PFS) was defined as the time of diagnosis to time of recurrence/death or last follow-up. The Kaplan–Meier method was used to calculate the PFS rate and the Wilcoxon–Gehan test was performed to identify prognostic factors.ResultsA total of 266 patients were identified. The median age was 43 years (range, 15–94 years). The majority of patients (68.4%) had FIGO stage I disease and serous histology (73.7%). Only 23 (8.6%) patients developed recurrent disease. The median PFS was 19 years and the median follow-up was 4 years. Abnormal baseline CA-125 (> 35 U/ml), advanced stage, age at diagnosis, and invasive implants were associated with decreased PFS. Of the 196 patients with serous BOT, those with a micropapillary pattern had a 3-year PFS of 75.9% (95%CI, 55.6–87.8) compared with 94.3% (95% CI, 88.4–97.3) for patients without micropapillary pattern (P < 0.001).ConclusionAge at diagnosis, an elevated preoperative CA-125, invasive implants, and micropapillary histology were clinical factors associated with increased risk of recurrence in women with BOT. Including these clinicopathologic features will likely identify patients at higher risk for recurrence, for whom development of new treatment strategies would be appropriate.

Research Highlights
► Preoperative CA-125 level is associated with recurrence of borderline ovarian tumors.
► Recurrence risk is increased with micropapillary tumors and invasive implants.