Outcome of patients with borderline ovarian tumors: Results of the multicenter AGO ROBOT study.

Gynecologic Cancer
Session Type and Session Title: 
Oral Abstract Session, Gynecologic Cancer
Abstract Number: 


J Clin Oncol 30, 2012 (suppl; abstr 5005)
Nikolaus De Gregorio, Klaus H. Baumann, Mignon-Denise Keyver-Paik, Alexander Reuss, Ulrich Canzler, Kerstin Wollschlaeger, Friedrich Kommoss, Dirk Forner, Martin Peters, Willibald Schroeder, Karsten Münstedt, Barbara Richter, Nina Ewald-Riegler, Sven Mahner, Christina Fotopoulou, Barbara Schmalfeldt, Felix Hilpert, Stefan Kommoss, Steffen Hauptmann, Andreas Du Bois; University of Ulm Medical Center, Ulm, Germany; Philipps University Marburg, Marburg, Germany; Department of Obstetrics and Gynecology, University Hospital Bonn, Bonn, Germany; AGO and Coordinating Center for Clinical Trials, Marburg, Germany; University of Dresden Department of Gynecology and Obstetrics, Dresden, Germany; University Medical Center Magdeburg, Department of Obstetrics and Gynecology, Magdeburg, Germany; Institute of Pathology, Referral Centre for Gynecopathology, Mannheim, Germany; Sana-Klinikum Remscheid, Department of Gynecology, Remscheid, Germany; Städtisches Klinikum Solingen, Department of Gynecology, Solingen, Germany; Gynecologicum Bremen, Bremen, Germany; University Hospital Giesen, Gießen, Germany; Elblandklinikum Radebeul, Radebeul, Germany; HSK, Dr. Horst Schmidt Klinik, Wiesbaden, Germany; University Medical Center Hamburg-Eppendorf, Department of Gynecology, Hamburg, Germany; European Competence Centre for Ovarian Cancer, Charite-University Hospital, Berlin, Berlin, Germany; Technical University of Munich, Munich, Germany; University Medical Center Kiel, Department for Obstetrics and Gynecology, Kiel, Germany; British Columbia Cancer Agency, Centre for Translational & Applied Genomics, Vancouver, BC, Canada; Institut für Pathologie Allgäu-Oberschwaben, Wangen, Germany; Kliniken Essen Mitte, Essen, Germany

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Abstract Disclosures


Background: Borderline ovarian tumors (BOT) are a rare entity; current standard of care is based on the available data of predominantly small retrospective trials. Therefore we performed a pattern of care study including central pathology review. Methods: All consecutive patients diagnosed with BOT between 1998 and 2008 in 24 German institutions were included. Tumor samples were prospectively sent for central histopathological review to specialized gynecopathologists, clinical data were collected and patient follow-up was prospectively updated. Results: Pathological review was obtained in 1,042 of 1,236 pts resulting in 950 confirmed BOT cases analyzed here. Under- and overdiagnosis occurred in 3.8% and 5.0% of cases, respectively. Median age was 49 years; 84% of patients had FIGO stage I disease; serous type (S-BOT) was diagnosed in 64% and mucinous type (M-BOT) in 31%. Primary/re-staging surgery led to complete debulking in 92.3% of pts (residual disease 1.3%, unknown 6.4%). Adjuvant chemotherapy was given to 33 (3.5%) pts only. 165 (17%) underwent fertility preserving surgery and 31 (19%) of these patients had documented pregnancies thereafter. Overall, 74 (7.8%) pts experienced relapse and 43 (4.5%) died. Disease progression in the form of invasive carcinoma occurred in 30% of the relapses. Inadequate surgical staging, residual tumor, fertility sparing surgery and higher FIGO stage were associated with shorter progression-free survival (PFS). M-BOT showed a non-significant trend to longer PFS compared to S-BOT (p = 0.07). No differences were observed for laparatomy vs. laparoscopy as initial surgical approach or application of adjuvant chemotherapy. Conclusions: To this day, this is the largest data set available for BOT. Prognosis is favorable even without adjuvant therapy if correct surgical staging is performed. Both tumor characteristics and treatment variables had a significant impact on relapse rate and outcome. In contrast to previous studies, disease progression in the form of invasive carcinoma occurred in a significant amount of patients with relapsed disease.