When to Worry About Cancer: Factors Associated With a Concurrent Carcinoma in Borderline Epithelial Ovarian Tumors [9J

Abstract

INTRODUCTION: Borderline ovarian tumors are technically benign yet can actually metastasize, recur, or progress to a carcinoma (typically low grade). The objective was to assess the outcomes of epithelial ovarian borderline tumors to determine factors potentially implicated in adverse outcomes. METHODS: The pathology and cancer databases were searched at an academic tertiary care center to identify all borderline tumors. Clinical data were abstracted via chart review. Borderline cases with/without a concurrent carcinoma were compared using relevant statistical tests and factors for any recurrence assessed. RESULTS: A total of 123 borderline patients were identified. The mean age at diagnosis was 51.3 years, mean BMI was 31.5 kg/m2, 82% were white, 83.7% underwent BSO +/- hysterectomy/omentectomy, median time to recurrence was 16.8 months, and over 90% were disease free. An additional ovarian cancer diagnosis occurred in 25% (half low grade, three high grade, and 11 unknown grade). Compared to the borderline only group, the carcinoma/borderline patients did not differ significantly in age, race, BMI, parity, HRT, tobacco use, or personal/family cancer history, but were significantly more likely to be postmenopausal and have an elevated Ca-125. Additionally, the cancer patients had significantly decreased serous histology and increased mucinous or endometrioid histologies. CONCLUSION: Concurrent ovarian cancer is common in women with borderline tumors and is associated with postmenopausal status and elevated Ca-125 levels. While the majority of cancers were still serous, there was a higher percentage of mucinous and endometrioid histologies. These factors should alert clinicians to a potential increased likelihood of concurrent cancer.