Surgical management and perioperative morbidity of patients with primary borderline ovarian tumor (BOT).

Gynecologic Cancer
Session Type and Session Title: 
This abstract will not be presented at the 2013 ASCO Annual Meeting but has been published in conjunction with the meeting.
Abstract Number: 
J Clin Oncol 31, 2013 (suppl; abstr e16535)
Fabian Trillsch, Jan David Ruetzel, Uwe Herwig, Ulrike Doerste, Linn Lena Woelber, Donata Grimm, Matthias Choschzick, Fritz Jaenicke, Sven Mahner; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Albertinen-Krankenhaus, Hamburg, Germany; University Medical Center Hamburg-Eppendorf, Department of Gynecology, Hamburg, Germany

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Abstract Disclosures


Background: Surgery is the central aspect of clinical management in patients with borderline ovarian tumors (BOT). As patients have excellent overall prognosis after successful surgery, perioperative morbidity is a critical point for decision regarding the primary surgical approach. Methods: Clinical and surgical parameters of patients undergoing surgery for primary BOT at two gynecologic cancer centers between 1993 and 2008 were analyzed with regard to perioperative morbidity depending on the surgical approach (laparoscopy vs. laparotomy). Results: A total of 105 patients were analyzed (44 with primary laparoscopy [42%], 61 with primary laparotomy [58%]). Primary laparoscopy was often performed with diagnostic intention and resulted in complete surgical staging in only 9.1% with subsequent formal indication for re-staging procedures. In contrast, complete surgical staging was achieved in 47.5% at primary laparotomy (p < 0.001). Tumor rupture was significantly more frequent during laparoscopy compared to laparotomy (29.5% vs. 13.1%, p = 0.038) but no other intraoperative complications were seen in laparoscopic surgery in contrast to 7 of 61 laparotomies (0% vs. 11.5%, p = 0.020). Postoperative complication rates were similar in both groups (19.7% vs. 18.2%, p = 0.848). Conclusions: Irrespective of the surgical approach, surgical management of BOT has acceptable rates of perioperative complications and morbidity. Choice of initial surgical approach can therefore be made independent of complication-concerns. As the recently published large retrospective AGO ROBOT study observed similar oncologic outcome for both approaches, laparoscopy should be considered as the preferred surgical approach for staging of patients with BOT if this appears feasible in preoperative evaluation.