BORDERLİNE OVARİAN TUMORS:DİAGNOSİS, TREATMENT & FOLLOW-UP

Öz

Borderline ovarian tumor (BOT), also known as tumors of low malignant potential, represent 10-20% of all ovarian malignancies. Histologically, the majority of BOTs are serous or mucinous; however, they may also have clear cell, endometrioid, Brenner (transitional cell) or mixed histology. As they frequently affect younger patients the clinical management is complicated by considerations such as preserving fertility and reducing postoperative morbidity. Due to the absence of specific preoperative criteria, diagnosis is often made during surgery or after the anatomopathologic examination. This review will attempt to inform readers about the recent data concerning these topics.

Anahtar Kelimeler

• : Borderline ovarian tumor
• surgical treatment
• FOLLOW-UP

BORDERLİNE OVER TÜMÖRLERİ: TANI,TEDAVİ, TAKİP

Öz

Düşük malignite potansiyelli over tümörü olarak bilinen, Borderline over tümörü (BOT), tüm over malignitelerinin %10 - 20’si kadardır. BOT’un en sık görülen histolojik tipleri sırasıyla seröz ve müsinöz tiplerdir, daha nadir olarak endometrioid, şeffaf hücreli, transisyonel ve miks tipler vardır. Hastalar sıklıkla daha genç yaşlarda tanı alırlar, bu yüzden hastalığın klinik yönetiminde, fertilite koruyucu ve postoperatif morbiditeyi azaltıcı yöntemler kullanılmalıdır. BOT’un ameliyat öncesi tanınması mümkün değildir, sıklıkla cerrahi esnasında frozen section veya operasyon sonrası over dokusunun histolojik incelenmesi ile tanı alır. Bu makale, okuyucuya BOT ile ilgili son yayımlanan bilgileri sunmayı hedeflemiştir.

Anahtar Kelimeler

• Borderline over tümörü
• cerrahi tedavi
• TANI

Kaynakça

1. 1. Taylor HC Jr. Malignant and semi-malignant tumors of the ovary. Surg Gynecol Obstset. 1929;48:204-230.
2. 2. Morice P, Uzan C, Fauvet R, Gouy S, Duvillard P, Darai E. Borderline ovarian tumour: pathological diagnostic dilemma and risk factors for invasive or lethal recurrence. Lancet Oncol 2012; 13(3):e103–e115.
3. 3. Sherman ME, Mink PJ, Curtis R et al. Survival among women with borderline ovarian tumors and ovarian carcinoma: A population-based analysis. Cancer 2004;100:1045–1052.
4. 4. Mink P, Sherman ME, Devesa S. Incidence patterns of invasive and borderline ovarian tumors among white women and black women in the United States: results from the SEER program, 1978–1997. Cancer 2002; 95: 2380–89.
5. 5. Morice P. Borderline tumours of the ovary and fertility. Eur J Cancer 2006;42:149 –158.
6. 6. Guvenal T, Dursun P, Hasdemir P et al. Effect of surgical staging on 539 patients with borderline ovarian tumors: A Turkish Gynecologic Oncology Group study Gynecologic Oncology 2013;131:546–550
7. 7. Gungor T, Cetinkaya N, Yalcin H et al. Retrospective evaluation of borderline ovarian tumors: single center experience of 183 cases Arch Gynecol Obstet 2015; 291:123–130.
8. 8. Heintz AP, Odicino F, Maisonneuve P et al. Carcinoma of the ovary. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2006;95:S161–S192.

9. 9. Van Leeuwen FE, Klip H, Mooij TM et al. Risk of borderline and invasive ovarian tumours after ovarian stimulation for in vitro fertilization in a large Dutch cohort.Hum Reprod 2011;26:3456 –3465.
10. 10. Tropé C, Davidson B, Paulsen T et al. Diagnosis and treatment of borderline ovarian neoplasms ‘the state of the art’. Eur J Gynaecol Oncol 2009; 30: 471–482.
11. 11. Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors. The Oncologist 2012;17:1515–1533.
12. 12. Tropé CG, Kaern J et al. Borderline ovarian tumours. Best Practice & Research Clinical Obstetrics and Gynaecology 26 2012; 325–336
13. 13. Camilla F. Gosvig, Susanne K. Kjaer, Jan Blaak Æ R et al. Coffee, tea, and caffeine consumption and risk of epithelial ovarian cancer and borderline ovarian tumors: Results from a Danish case-control study. Acta Oncologica, 2015; Early Online: 1–8.
14. 14. Harter P, Gershenson D, Lhomme C et al.Gynecologic Cancer InterGroup (GCIG) Consensus Review for Ovarian Tumors of Low Malignant Potential (Borderline Ovarian Tumors). International Journal of Gynecological Cancer & Volume. 2014; 24, Number S3, November.
15. 15. Song T, Lee YY, Choi CH, Kim TJ et al. Borderline ovarian tumor in women aged _65 years: impact on recurrence and survival. European Journal of Obstetrics & Gynecology and Reproductive Biology 184 2015; 38–42
16. 16. du Bois A, Ewald-Riegler N, de Gregorio N, et al. Borderline tumours of the ovary: a cohort study of the Arbeitsgemeinschaft Gyna¨kologische Onkologie (AGO) Study Group. Eur J Cancer. 2013; 49:1905-1914.
17. 17. Tinelli R, Tinelli A, Tinelli FG et al. Conservative surgery for borderline ovarian tumors: A review. Gynecol Oncol 2006;100:185–191.
18. 18. du Bois A, Ewald-Riegler N, du Bois O et al. Borderline tumors of the ovary: A systematic review. Geburtsh Frauenheilk 2009;69:807– 833.
19. 19. Trillsch F, Mahner S, Ruetzel J et al. Clinical management of borderline ovarian tumors. Expert Rev Anticancer Ther 2010; 10:1115–1124.
20. 20. Cadron I, Leunen K, Van Gorp T et al. Management of borderline ovarian neoplasms. J Clin Oncol 2007; 25: 2928–2937.
21. 21. Bjørge T, Engeland A, Hansen S et al. Prognosis of patients with ovarian cancer and borderline tumours diagnosed in Norway between 1954 and 1993. Int J Cancer 1998; 75: 663–670.
22. 22. C. Uzan, E. Muller, A. Kane et al. Prognostic factors for recurrence after conservative treatment in a series of 119 patients with stage I serous borderline tumors of the ovary Annals of Oncology 25: 166–171 Published online 2013; 28 November.
23. 23. Oedegaard E. Ovarian carcinomas and borderline ovarian tumors - molecular markers and operative treatment. Dissertation, Facutly of Medicine, University of Oslo, 2008.
24. 24. Loizzi V, Selvaggi L, Leone L et al. Borderline epithelial tumors of the ovary: Experience of 55 patients. Oncology Letters 2015; 9: 912-914.
25. 25. Morice P. Borderline tumours of the ovary and fertility. Eur J Cancer 2006;42:149 –158.
26. 26. Coumbos A, Sehouli J, Chekerov R, et al. Clinical management of borderline tumours of the ovary: results of a multicentre survey of 323 clinics in Germany. Br J Cancer. 2009;100:1731-1738.
27. 27. Baker P, Oliva E. A practical approach to intraoperative consultation in gynecological pathology. Int J Gynecol Pathol. 2008;27:353-365.
28. 28. Van Calster B, Van Hoorde K, Valentin L et al. International Ovarian Tumour Analysis (IOTA) group Evaluating the risk of ovarian cancer before surgery using the ADNEX model to differentiate between benign, borderline, early and advanced stage invasive, and secondary metastatic tumours: prospective multicentre diagnostic study BMJ 2014;349:g5920.
29. 29. Van Gorp T, Veldman J, Van Calster B et al. Subjective assessment by ultrasound is superior to the risk of malignancy index (RMI) or the risk of ovarian malignancy algorithm (ROMA) in discriminating benign from malignant adnexal masses. Eur J Cancer 2012;48:1649–1656.
30. 30. Seidman JD, Horkayne-Szakaly I, Haiba M et al. The histologic type and stage istribution of ovarian carcinomas of surface epithelial origin. Int J Gynecol Pathol 2004; 23: 41–44.
31. 31. Turan T, Cirik DA et al. Frozen section in borderline ovarian tumors: is it reliable? Eur J Obstet Gynecol Reprod Biol. 2014 Oct;181:115-8.