Clinical characteristics and outcome for treatment for borderline ovarian tumor in King Chulalongkorn Memorial Hospital

Background: Borderline ovarian tumor (BOT) is a distinct diagnosis which comprises 5%-15% of epithelial ovarian tumor. Borderline ovarian tumor is characterized histologically as an epithelial tumor with stratified growth pattern without destructive stromal invasion. From observation, BOT in our institution is more common in the mucinous cell type, as distinct from that reported in previous reviews.

Objective: This study was conducted to evaluate characteristics, treatment outcome and recurrence of BOT in our institution.

Methods: A retrospective review was made of the medical records of BOT patients to collect data. From 2006 to 2010, all 55 cases of BOT were reviewed from the aspect of general characteristics, presenting symptoms, tumor markers, pathologic diagnosis, operations, treatment outcome, and recurrence.

Results: The median age of the 55 BOT patients was 42 years. The common presenting symptoms were palpable mass, abdominal discomfort, and pelvic pain. One fourth of the patients had no symptoms. Mucinous cells were the most common subtype histologically (72.7%). Serous cell subtype were found in 21.8%. The most common surgical procedure was salpingo-oophorectomy. Median follow up time was 38 months. There was recurrence of 5 cases (9.1%) and recurrence was more common in the patients with a serous cell subtype and those who had residual tumors after primary surgery. A higher stage of disease was also associated with a greater risk of recurrence.

Conclusion: While most previous studies showed that a serous cell subtype was the most common subtype, our study found the mucinous cell subtype was the most common at our institution. Recurrence was quite common in patients with the mucinous cell subtype with microinvasion, and was more common in patients with residual tumors after primary surgery. From the aspect of recurrence, these findings were not different from those of previous studies. The optimal treatment of recurrence remains controversial.