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Li Y, Zhao W, Chen P, Zeng W, Xu Y, Peng J, Li J. Infertile women with a history of fertility-sparing surgery for borderline ovarian tumors: IVF outcomes and the association between IVF and tumor recurrence. Reprod Biol Endocrinol 2025; 23:63. [PMID: 40336050 PMCID: PMC12057225 DOI: 10.1186/s12958-025-01397-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2025] [Accepted: 04/20/2025] [Indexed: 05/09/2025] Open
Abstract
BACKGROUND Borderline ovarian tumors (BOTs) are neoplasms of low malignant potential that predominantly affect women of reproductive age. Fertility preservation through fertility-sparing surgery is widely practiced; however, concerns remain regarding the risk of tumor recurrence and the reproductive outcomes following in vitro fertilization (IVF). This study aimed to evaluate IVF/ intracytoplasmic sperm injection (ICSI) outcomes in BOTs patients post-FSS and to assess the association between ovarian stimulation parameters and tumor recurrence. METHODS In this retrospective cohort study conducted at Sixth Hospital of Sun Yat-sen University from May 2010 to May 2023, 65 women with a history of FSS for BOTs who underwent IVF/ICSI were identified. After propensity score matching, 61 BOTs patients were compared with 181 control patients without ovarian tumors. Key outcomes evaluated included ovarian stimulation parameters, live birth rates, neonatal outcomes and risk factors for tumor recurrence. RESULTS The BOTs and control groups exhibited similar outcomes regarding the number of oocytes retrieved, the quality and number of embryos, and live birth rates from the first IVF/ICSI cycles. The cumulative live birth rate over 13 years and neonatal parameters (gestational age, birth weight, and body length) were also comparable between groups. Tumor recurrence was observed in 8.62% of BOTs patients, with no significant association identified between recurrence and ovarian stimulation parameters or peak estradiol levels. CONCLUSIONS IVF/ICSI following fertility-sparing surgery for BOTs patients yields reproductive and neonatal outcomes comparable to those in patients without BOTs and does not increase the risk of tumor recurrence. These findings support the safety and efficacy of IVF as a fertility treatment option for BOTs patients after conservative surgery. Further prospective studies with larger cohorts are warranted to validate these results and refine ovarian stimulation strategies. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Yujie Li
- Reproductive Medicine Research Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Weie Zhao
- Reproductive Medicine Research Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Panyu Chen
- Reproductive Medicine Research Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Weiwei Zeng
- Department of Pharmacy, Shenzhen Longgang Second People's Hospital, Shenzhen, 518112, China
| | - Yaqi Xu
- Department of Health Statistics & The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, The Fourth Military Medical University, Xian, 710032, China
| | - Jintao Peng
- Reproductive Medicine Research Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
| | - Jingjie Li
- Reproductive Medicine Research Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
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Raimondo D, Raffone A, Maletta M, Restaino S, Arcieri M, Driul L, Travaglino A, Perrone AM, Fagotti A, Mascilini F, Malzoni M, Falcone F, Bogani G, Ferla S, Landoni F, Berretta R, Ceccaroni M, Cicogna S, Pantano F, Trojano G, Sami K, Chiara C, Chiantera V, Alboni C, Solima E, Scarfone G, Martinello R, Manna P, Pecorino B, Vastarella MG, Calandra D, Paccapelo A, Lenzi J, Cobellis L, Scambia G, Vizzielli G, Seracchioli R. Hysterectomy or not for borderline ovarian tumor in menopause? Gynecol Oncol 2025; 196:152-159. [PMID: 40209444 DOI: 10.1016/j.ygyno.2025.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2024] [Revised: 03/25/2025] [Accepted: 03/30/2025] [Indexed: 04/12/2025]
Abstract
BACKGROUND The role of hysterectomy for borderline ovarian tumor (BOT) among postmenopausal women is still unclear. OBJECTIVE(S) To assess the impact of hysterectomy on survival outcomes in postmenopausal women with BOT. STUDY DESIGN This study was a national, multicenter, observational, retrospective, cohort study including all consecutive eligible postmenopausal patients who underwent primary surgery for BOT in 20 Italian centers from January 2005 to December 2017. Patients were divided into two groups: hysterectomy group vs no-hysterectomy group. Primary outcome was disease-free survival (DFS) at 5 years of follow-up; secondary outcomes were overall survival (OS) and disease-specific survival (DSS) at 5 years of follow-up, hazard ratio (HR) for recurrence, death of any cause and death due to BOT, peri-operative complications rates. RESULTS 483 patients were included, 144 (29.8 %) women in the no-hysterectomy group and 339 (70.2 %) in the hysterectomy group. Recurrences were significantly more common in the no-hysterectomy group compared to hysterectomy one (8.3 % vs 2.7 %; p = 0.012). The 5-year DFS rate was lower in the no-hysterectomy group than that in the hysterectomy one [92.4 % vs 98.5 %; p = 0.007]. At univariate analyses, women who underwent hysterectomy showed HR of 0.312 (95 %CI:0.131-0.740; p = 0.008) for recurrence. At multivariate analysis, hysterectomy was found to be an independent protective factor for recurrence (HR: 0.253, 95 %CI:0.103-0.618, p < 0.003). CONCLUSIONS In postmenopausal women with BOT, hysterectomy is associated with a decreased risk of recurrence, while it does not affect the risk of death from any cause or death due to the disease. Based on these findings, hysterectomy should be routinely integrated into the surgical staging of BOT in postmenopausal women.
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Affiliation(s)
- Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Raffone
- Department of Medical and Surgical Sciences, DIMEC, University of Bologna, Bologna, Italy; Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
| | - Manuela Maletta
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, DIMEC, University of Bologna, Bologna, Italy.
| | - Stefano Restaino
- Clinic of Obstetrics and Gynecology, "Santa Maria della Misericordia" University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; School in Biomedical Sciences, Gender Medicine, Child and Women Health, University of Sassari, Sassari, Italy
| | - Martina Arcieri
- Clinic of Obstetrics and Gynecology, "Santa Maria della Misericordia" University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, "Santa Maria della Misericordia" University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Department of Medicine, University of Udine, Udine, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
| | - Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Anna Fagotti
- Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Rome, Italy
| | - Floriana Mascilini
- Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Mario Malzoni
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | - Francesca Falcone
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | - Giorgio Bogani
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Stefano Ferla
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, DIMEC, University of Bologna, Bologna, Italy
| | - Fabio Landoni
- Gynecologic Clinic Milano Bicocca University, Ospedale San Gerardo, Monza, Italy
| | - Roberto Berretta
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Stefania Cicogna
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Italy
| | - Francesco Pantano
- Ginecologia oncologica Ospedale Civile di Legnano ASST Ovest Milanese, Italy
| | - Giuseppe Trojano
- Department of Maternal and Child Health "Madonna delle Grazie" Hospital ASM Matera, Italy
| | | | - Cassani Chiara
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Unit of Obstetrics and Gynecology, IRCCS San Matteo Foundation, Pavia, Italy
| | - Vito Chiantera
- Istituto Nazionale Tumori IRCS- Fondazione G. Pascale, Napoli, Italy
| | - Carlo Alboni
- Minimally Invasive and Robotic Gynecologic Surgery Unit, Policlinico Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Eugenio Solima
- Asst Fatebenefratelli-sacco, ospedale Macedonio Melloni Milano, Italy
| | | | - Ruby Martinello
- Institute of Obstetrics and Gynecology, Department of Medical Sciences, University of Ferrara, Italy
| | - Paolo Manna
- Department of Clinical and Experimental Medicine, Obstetrics and Gynecology Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Basilio Pecorino
- Obstetrics and Gynecological Unit, Cannizzaro Hospital Department of Medicine and Surgery, University of Enna "Kore", 94100 Enna, Italy
| | - Maria Giovanna Vastarella
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Davide Calandra
- Ginecologia ed ostetricia AULSS7 Pedemontana-Ospedale di Santorso, Università degli Studi "G.D'Annunzio" di Chieti e Pescara, Italy
| | - Alexandro Paccapelo
- Epidemiology and Statistics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Luigi Cobellis
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giovanni Scambia
- Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Rome, Italy
| | - Giuseppe Vizzielli
- Clinic of Obstetrics and Gynecology, "Santa Maria della Misericordia" University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Department of Medicine, University of Udine, Udine, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, DIMEC, University of Bologna, Bologna, Italy
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Sadlecki P, Dejewska K, Domieracka P, Walentowicz-Sadlecka M. Giant mucinous borderline ovarian tumor: challenges of diagnosis and treatment. Arch Gynecol Obstet 2025; 311:1205-1207. [PMID: 39441405 PMCID: PMC11985592 DOI: 10.1007/s00404-024-07793-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 10/12/2024] [Indexed: 10/25/2024]
Affiliation(s)
- Pawel Sadlecki
- Medical Department, University of Science and Technology, Bydgoszcz, Poland.
- Department of Obstetrics, Gynecology and Gynecologic Oncology, Regional Polyclinical Hospital, Grudziadz, Poland.
| | - Katarzyna Dejewska
- Department of Obstetrics, Gynecology and Gynecologic Oncology, Regional Polyclinical Hospital, Grudziadz, Poland
| | - Patrycja Domieracka
- Department of Obstetrics, Gynecology and Gynecologic Oncology, Regional Polyclinical Hospital, Grudziadz, Poland
- Department of Obstetrics Gynecology and Gynecologic Oncology, Regional Polyclinical Hospital, Torun, Poland
| | - Malgorzata Walentowicz-Sadlecka
- Medical Department, University of Science and Technology, Bydgoszcz, Poland
- Department of Obstetrics, Gynecology and Gynecologic Oncology, Regional Polyclinical Hospital, Grudziadz, Poland
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Azzopardi MJ, Calleja-Agius J, Calleja N, Galea D, Ellul B, Micallef R, O'Toole SA, Savona-Ventura C. Rare gynaecological cancers in Malta - An analysis of incidence between 2010 and 2021. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2025; 51:109971. [PMID: 40148197 DOI: 10.1016/j.ejso.2025.109971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 02/20/2025] [Accepted: 03/10/2025] [Indexed: 03/29/2025]
Abstract
INTRODUCTION Whilst about 18 % of all cancers in females are gynaecological cancers, more than 50 % of these can be classified as rare tumours (defined as an annual incidence of <6 per 100,000). Such cancers represent an important challenge for small countries like Malta where the small caseload may limit the expertise of clinicians in the diagnosis and treatment of such cancers. METHODOLOGY The study uses data from the Maltese population-based cancer registry to examine trends in incidence rate of the rare gynaecological cancers for the 12-year period between 2010 and 2021. It employs the RARECAREnet list to identify the rare gynaecological cancers by major rare gynaecological cancer categories and histological types and analyses the number of cases and incidence rates in Malta to monitor trends and provide an insight of the burden of such cancers. RESULTS A total of 709 new cases of rare gynaecological cancers were discovered during the 12-year period. Globally, these rare gynae cancers, constituted 42.6 % of all the gynae cancers that occurred during this period. Most of these rare cancers were ovarian (399 cases, 56.3 %), followed by rare cancers of the vulva and vagina (122 cases, 17.21 %), rare cancers of the corpus uteri (93 cases, 13.12 %) and rare cancers of the cervix uteri (73 cases, 10.3 %). Other rare gynaecological cancers (10 cases, 1.41 %) and cancers of the placenta (2 cases, 0.04 %) were much rarer. The outcomes in terms of 5-year survival was worse for the rare cancers compared with the commoner types of gynae cancers with an overall 5-year survival of 45.10 % and 45.48 % for rare gynae cancers for the 2010-2014 and 2015-2019 cohorts respectively and an overall 5-year survival of 69.94 % and 73.44 % for the common gynae cancers for the 2010-2014 and 2015-2019 cohorts respectively. CONCLUSION The study shows that globally rare gynaecological cancers in a small state like Malta are in fact not so rare - with a total of 709 rare gynaecological cancers in 12 years for Malta. These cases are however few when considering that they are divided into over 30 different histopathological groups. Numbers are also small when it comes to accumulating statistical power for analysis. The caseload for the individual sub-categories is small and will often be shared amongst the different individual gynaecologists and/or their clinical team. Thus, it might be difficult for these specialists to gather enough technical expertise that is crucial for early diagnosis and the treatment of these rare cancers. This study provides a rationale for international collaboration where there is scope for joint research and sharing of expertise. Establishment of common databases for the various types of rare gynaecological tumours will provide statistical power, enabling analysis of outcomes for these rare cancers and establishment of guidelines.
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Affiliation(s)
- Miriam J Azzopardi
- Directorate for Health Information and Research, 95, G'Mangia Hill, Pietà, PTA 1313, Malta.
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta.
| | - Neville Calleja
- Directorate for Health Information and Research, 95, G'Mangia Hill, Pietà, PTA 1313, Malta.
| | - Darren Galea
- Directorate for Health Information and Research, 95, G'Mangia Hill, Pietà, PTA 1313, Malta.
| | - Bridget Ellul
- Centre for Molecular Medicine & Biobanking, University of Malta, MSD 2080, Msida, Malta.
| | - Rita Micallef
- Directorate for Health Information and Research, 95, G'Mangia Hill, Pietà, PTA 1313, Malta.
| | - Sharon A O'Toole
- Departments of Obstetrics and Gynaecology and Histopathology, Trinity St James's Cancer Institute, Trinity College Dublin, Dublin 8, Ireland.
| | - Charles Savona-Ventura
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta.
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He D, Jin L, Geng H, Cao L. Deep learning-based analysis of gross features for ovarian epithelial tumors classification: A tool to assist pathologists for frozen section sampling. Hum Pathol 2025; 157:105762. [PMID: 40122402 DOI: 10.1016/j.humpath.2025.105762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2025] [Revised: 03/18/2025] [Accepted: 03/21/2025] [Indexed: 03/25/2025]
Abstract
Computational pathology has primarily focused on analyzing tissue slides, neglecting the valuable information contained in gross images. To bridge this gap, we proposed a novel approach leveraging the Swin Transformer architecture to develop a Swin-Transformer based Gross Features Detective Network (SGFD-network), which assist pathologists for locating diseased area in ovarian epithelial tumors based on their gross features. Our model was trained on 4129 gross images and achieved high accuracy rates of 88.9 %, 86.4 %, and 93.0 % for benign, borderline, and carcinoma group, respectively, demonstrating strong agreement with pathologist evaluations. Notably, we trained a new classifier to distinguish between borderline tumors and those with microinvasion or microinvasive carcinoma, addressing a significant challenge in frozen section sampling. Our study was the first to propose a solution to this challenge, showcasing high accuracy rates of 85.0 % and 92.2 % for each group, respectively. To further elucidate the decision-making process, we employed Class Activation Mapping-grad to identify high-contribution zones and applied k-means clustering to summarize these features. The resulting clustered features can effectively complement existing knowledge of gross examination, improving the distinction between borderline tumors and those with microinvasion or microinvasive carcinoma. Our model identifies high-risk areas for microinvasion or microinvasive carcinoma, enabling pathologists to target sampling more effectively during frozen sections. Furthermore, SGFD-network requires only a single 4090 graphics card and completes a single interpretation task in 3 min. This study demonstrates the potential of deep learning-based analysis of gross features to aid in ovarian epithelial tumors sampling, especially in frozen section.
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Affiliation(s)
- Dong He
- Department of Pathology, The Second Hospital of Jilin University, Jilin University, Jilin, Changchun, 130041, PR China; State Key Laboratory of Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, Jilin, Changchun, 130022, PR China
| | - Longhai Jin
- Department of Radiology, The Second Hospital of Jilin University, Jilin University, Jilin, Changchun, 130041, PR China
| | - Hanhan Geng
- Jilin Province Economic Management Cadre College, Jilin, Changchun, 130022, PR China
| | - Lanqing Cao
- Department of Pathology, The Second Hospital of Jilin University, Jilin University, Jilin, Changchun, 130041, PR China.
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Jara P, De Pace LA, Piña IB, Carballeira CC, Buznego LA, Ferré ADJ. Recurrence rate and quality of life in women with borderline ovarian tumours, according to surgical approach. Eur J Obstet Gynecol Reprod Biol 2025; 306:125-131. [PMID: 39824149 DOI: 10.1016/j.ejogrb.2025.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 10/30/2024] [Accepted: 01/07/2025] [Indexed: 01/20/2025]
Abstract
OBJECTIVES To assess the recurrence rate and quality of life (QOL) in women with a history of borderline ovarian tumours (BOTs) based on the type of surgery (conservative vs non-conservative) in Spain. STUDY DESIGN A retrospective analysis was conducted of 85 women treated for BOTs between 2007 and 2023 at two hospitals. QOL questionnaires were administered face-to-face to eligible patients. Individuals with dementia, living in an institution, or residing outside the region were excluded from this study. MAIN OUTCOME MEASURES General characteristics and the recurrence rate were analysed retrospectively. Three validated questionnaires - European Organisation for Research and Treatment of Cancer (EORTC) core QOL questionnaire for patients with cancer (QLQ-C30), EORTC QOL questionnaire for patients with ovarian cancer (QLQ-OV28) and Menopause Rating Scale II (MRS II) - were used to assess QOL in eligible patients. RESULTS The recurrence rate was low (5.9 %) and the disease-specific overall survival rate was high with only two (2.4 %) deaths. International Federation of Gynecology and Obstetrics stage III disease [odds ratio (OR) 58.5, 95 % confidence interval (CI) 6.02-568.53; p < 0.0001] and positive peritoneal cytology (OR 26, 95 % CI 2.68-252.68; p = 0.005] were associated with recurrence. No association was found between the type of surgery (conservative vs non-conservative) and QOL. Older age was associated with poorer sexual function scores on QLQ-OV28. CONCLUSIONS This study highlights the need for careful evaluation of each case. The current evidence does not recommend conservative surgery to improve QOL.
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Affiliation(s)
- Pablo Jara
- Medical Oncology Department, Gregorio Marañón University Hospital, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - Laura Aller De Pace
- Gynaecology and Obstetrics Department, Marqués de Valdecilla University Hospital, Cantabria, Spain
| | - Isabel Bernat Piña
- Medical Oncology Department, Basurto University Hospital, País Vasco, Spain
| | - Clara Castro Carballeira
- Medical Oncology Department, Marqués de Valdecilla University Hospital, IDIVAL, Cantabria, Spain
| | - Lucía Alonso Buznego
- Medical Oncology Department, Marqués de Valdecilla University Hospital, IDIVAL, Cantabria, Spain
| | - Ana de Juan Ferré
- Medical Oncology Department, Marqués de Valdecilla University Hospital, IDIVAL, Cantabria, Spain
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Laboret B, Scrushy MG, Pandya S, Murphy JT. Pediatric Borderline Ovarian Tumors: A Retrospective Study of 15 Cases at a Single Institution. J Pediatr Hematol Oncol 2025; 47:e77-e82. [PMID: 39804042 DOI: 10.1097/mph.0000000000002998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 12/31/2024] [Indexed: 02/26/2025]
Abstract
Borderline ovarian tumors (BOTs) are rare in pediatric populations and typically follow an indolent clinical course with few reported recurrences. Consequently, guidelines for pediatric BOT management are minimal. We retrospectively examined the management of 15 adolescent patients who underwent BOT resection at our institution over 14 years, with a specific focus on recurrence. Data collected include age, symptoms, tumor characteristics, laboratory markers, surgical management, staging, and follow-up. Fifteen patients with BOTs (median age: 16 y) presented with abdominal pain (67%), or distention (33%). Cancer antigen-125 marker was elevated in 10/13 patients. There were 11 (73%) tumors with serous and 4 (23%) with mucinous histology. Most received fertility-preserving surgery (93%) and disease stage was 1A in 7 (47%), 1B/1C in 5 (33%), and stage 2B or higher in 3 (20%) patients. Additional staging procedures, including peritoneal washings (73%), omentectomy (53%), and peritoneal biopsy (47%), varied in use. Four (27%) patients recurred, with 1 case of benign tumor, 1 BOT, and 2 serous carcinomas. Median patient follow-up was 45 months. BOTs can be successfully treated with fertility-preserving surgery but demonstrate a non-negligible rate of recurrence. We recommend surgical staging and posttreatment surveillance for all patients with BOT.
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Affiliation(s)
- Bretton Laboret
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Marinda G Scrushy
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Pediatric Surgery, Children's Medical Center, Dallas, TX
| | - Samir Pandya
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Pediatric Surgery, Children's Medical Center, Dallas, TX
| | - Joseph T Murphy
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Pediatric Surgery, Children's Medical Center, Dallas, TX
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Drymiotou S, Theodorou E, Rallis KS, Nicolaides M, Sideris M. Molecular Biomarkers in Borderline Ovarian Tumors: Towards Personalized Treatment and Prognostic Assessment. Cancers (Basel) 2025; 17:545. [PMID: 39941911 PMCID: PMC11816664 DOI: 10.3390/cancers17030545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2024] [Revised: 01/26/2025] [Accepted: 01/29/2025] [Indexed: 02/16/2025] Open
Abstract
Borderline Ovarian Tumours (BOTs) are a heterogenous group of ovarian neoplasms which have increased mitotic activity but lack stromal invasion. We performed a narrative review of the literature, aiming to identify prognostic molecular biomarkers that can potentially be used for treatment personalisation. We identified and discussed BRAF/KRAS, Cancer Antigen 125 (Ca 125), Calprotectin, p16ink4a, and Microsatellite instability (MSI) as the most studied biomarkers related to BOTs. Overall, BRAF and KRAS mutations are associated with earlier-stage and favourable prognosis; KRASmt may indicate extraovarian disease in serous BOT (sBOT). Ca125, the only currently clinically used biomarker, can be assessed pre-operatively and has an established role in post-operative surveillance, especially when it is raised pre-operatively or a high potential for malignant transformation is suspected post-operatively. p16ink4a expression trends could also indicate the malignant transformation of the tumour. Calprotectin has an inferior specificity to Ca125 and is not yet established as a biomarker, whilst there is very limited evidence available for MSI. As new evidence is coming along with artificial intelligence platforms, these biomarkers can be integrated and used towards the development of a precision model for treatment stratification and counselling in women diagnosed with BOTs.
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Affiliation(s)
- Stefania Drymiotou
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK; (S.D.); (E.T.); (K.S.R.)
| | - Efthymia Theodorou
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK; (S.D.); (E.T.); (K.S.R.)
| | - Kathrine Sofia Rallis
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK; (S.D.); (E.T.); (K.S.R.)
| | - Marios Nicolaides
- Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK;
| | - Michail Sideris
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK; (S.D.); (E.T.); (K.S.R.)
- Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square Campus, Barbican, London EC1M 6BQ, UK
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9
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Xie W, Zhang Q, Wang Y, Xiang Z, Zeng P, Huo R, Du Z, Tang L. Ultrasound-based ADNEX model for differentiating between benign, borderline, and malignant epithelial ovarian tumours. Clin Radiol 2025; 81:106761. [PMID: 39721319 DOI: 10.1016/j.crad.2024.106761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 11/02/2024] [Accepted: 11/25/2024] [Indexed: 12/28/2024]
Abstract
BACKGROUND The purpose of this study was to evaluate the ability of the International Ovarian Tumor Analysis-Assessment of Different NEoplasias in the adneXa (IOTA-ADNEX) model to distinguish among benign, borderline, and malignant epithelial ovarian tumours (BeEOTs, BEOTs, and MEOTs, respectively). METHODS The study included 813 patients with BeEOTs, BEOTs, and MEOTs who underwent ultrasound examinations and pelvic operations. Comparisons were made between the clinical information and ultrasonographic features of the three patient groups, and the histopathological diagnosis was the gold standard. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of the ADNEX model were calculated. RESULTS This was a single-centre retrospective study. Of the 813 patients, 257 (31.6%) had BeEOTs, 114 (14.0%) had BEOTs, and 442 (54.4%) had MEOTs. For a cut-off value of 10% to identify the overall risk for ovarian cancer (OC), the sensitivity and specificity were 99.1% and 73.2%, respectively. According to the receiver operating characteristicscurves, the AUC was 0.987 (95% CI: 0.981-0.993) for BeEOTs compared with MEOTs, 0.820 (95% CI: 0.768-0.872) for BeEOTs compared with BEOTs, 0.912 (95% CI: 0.876-0.948) for BeEOTs compared with stage I OC, and 0.995 (95% CI: 0.992-0.998) for BeEOTs compared with stages II-IV OC. The AUC was 0.614 (95% CI: 0.519-0.709) for BEOTs compared with stage I OC, 0.903 (95% CI: 0.869-0.937) for BEOTs compared with stages II-IV OC, and 0.851 (95% CI: 0.800-0.902) for stage I OC compared with stages II-IV OC. CONCLUSIONS The IOTA-ADNEX model demonstrated good diagnostic performance for the three categories of EOTs and may have the potential to be popularised in assisting radiologists in the assessment of adnexal masses in the future.
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Affiliation(s)
- W Xie
- Department of Ultrasound, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - Q Zhang
- Department of Ultrasound, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - Y Wang
- Department of Ultrasound, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - Z Xiang
- Department of Epidemiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - P Zeng
- Department of Ultrasound, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - R Huo
- Department of Clinical Laboratory, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, 350014, Fujian Province, China
| | - Z Du
- Department of Ultrasound, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - L Tang
- Department of Ultrasound, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China.
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10
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Rostagni OM, Early CL, Hodges MB, Obasohan JO, Sapp JC, Livinski AA, Biesecker LG, Ours CA. Tumour spectrum in AKT1-related Proteus syndrome: a systematic review of clinical reports and series. J Med Genet 2025; 62:74-81. [PMID: 39643433 PMCID: PMC12107491 DOI: 10.1136/jmg-2024-110173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 11/08/2024] [Indexed: 12/09/2024]
Abstract
AKT1-related Proteus syndrome is an ultra-rare mosaic overgrowth disorder with tumour predisposition. We conducted a systematic review to determine the range and characteristics of these tumours. A systematic review was conducted to identify clinical reports and clinical series of Proteus syndrome published between 1983 and 2023. Affected individuals were selected based on existing Proteus syndrome diagnostic criteria and expert review. Six databases were searched, and each unique record was screened independently by two authors. Two authors extracted the following data from each included report per individual: demographics, tumour diagnosis, characteristics, outcome, clinical features of Proteus syndrome and report of AKT1 genetic testing. The literature searches yielded 3074 records of which 1239 were unique and screened. After screening, 190 records were included. These represented 205 unique individuals with Proteus syndrome. There were 38 individuals (19%) with at least one tumour diagnosis. The average age of tumour diagnosis was 15.1 years (SD 12.1). The most frequent tumour sites were genitourinary/gynaecologic (25 tumours, 53%) followed by the central nervous system (11 tumours, 23%). Most tumours were benign and treated with surgery alone. This systematic review provides a summary of Proteus syndrome-associated tumours from the literature. These data assist clinicians in the diagnosis and prognosis of these tumours. The study highlights the knowledge gap of possible adult-onset tumours and long-term outcomes, which requires further research. PROSPERO registration number CRD42021237914.
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Affiliation(s)
- Olivia M Rostagni
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Charlotte Lr Early
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Mia B Hodges
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Justice O Obasohan
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Julie C Sapp
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Alicia A Livinski
- Office of Research Services, Office of the Director, National Institutes of Health Library, Bethesda, Maryland, USA
| | - Leslie G Biesecker
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Christopher A Ours
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, Maryland, USA
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11
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Mesarieki LV, Macheku GS, Kayombo GO, Minga BL, Sadiq A, Mremi A. A giant ovarian atypical proliferative mucinous tumor in a young adult: A rare case report and review of the literature. Int J Surg Case Rep 2025; 126:110753. [PMID: 39700580 PMCID: PMC11718320 DOI: 10.1016/j.ijscr.2024.110753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Revised: 12/09/2024] [Accepted: 12/15/2024] [Indexed: 12/21/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Ovarian atypical proliferative mucinous tumor (APMT) is a low-malignant or borderline tumor that originates from the ovary's surface epithelium. This tumor can grow to a massive size, causing abdominal distention, which can result in a variety of compression symptoms if it is not discovered early. CASE PRESENTATION A 23-year-old female presented with a chronic, gradually developing abdominal distention that had been persistent for a year. A large peritoneal cyst was suggested by an abdominal CT scan. A massive left ovarian tumor was discovered during an exploratory laparotomy. Salpingo-oophorectomy was performed, and the pathology report confirmed the diagnosis of APMT. No recurrence has been observed during a year of follow-up. CLINICAL DISCUSSION Diagnosis of ovarian APMBT involves clinical assessment, history, and symptoms of the patient. Imaging studies are useful in identifying these lesions. Ultrasound demonstrates a large, unilocular or multilocular cystic mass with thin septations. Further characterization requires an MRI or CT scan. Serum tumor markers such as CEA, CA-125, and β-hCG are helpful in diagnosing these lesions. The definitive diagnosis requires histopathological examination. Unilateral salpingo-oophorectomy is the mainstay of treatment. Adjuvant therapy is not required. Lifelong follow-up is essential, especially for fertility-sparing surgeries due to recurrence risk. CONCLUSION Due to the substantial overlap of clinicopathological characteristics with other tumors, accurate diagnosis of APMT can be difficult. Large tumor sizes may cause alarm for other pathologies such as cancer. The attending physician should be reassured with the imaging examinations, and the diagnosis is confirmed by the histopathology examination.
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Affiliation(s)
| | - Godwin Silas Macheku
- Department of Obstetrics and Gynecology, Mawenzi Regional Referral Hospital, Moshi, Tanzania
| | | | - Benard Laurent Minga
- Department of General Surgery, Mawenzi Regional Referral Hospital, Moshi, Tanzania
| | - Adnan Sadiq
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania; Department of Diagnostic Radiology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania; Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
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12
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Oliveira DVNP, Biskup E, O'Rourke CJ, Hentze JL, Andersen JB, Høgdall C, Høgdall EV. Developing a DNA Methylation Signature to Differentiate High-Grade Serous Ovarian Carcinomas from Benign Ovarian Tumors. Mol Diagn Ther 2024; 28:821-834. [PMID: 39414761 PMCID: PMC11512855 DOI: 10.1007/s40291-024-00740-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 10/18/2024]
Abstract
INTRODUCTION Epithelial ovarian cancer (EOC) represents a significant health challenge, with high-grade serous ovarian cancer (HGSOC) being the most common subtype. Early detection is hindered by nonspecific symptoms, leading to late-stage diagnoses and poor survival rates. Biomarkers are crucial for early diagnosis and personalized treatment OBJECTIVE: Our goal was to develop a robust statistical procedure to identify a set of differentially methylated probes (DMPs) that would allow differentiation between HGSOC and benign ovarian tumors. METHODOLOGY Using the Infinium EPIC Methylation array, we analyzed the methylation profiles of 48 ovarian samples diagnosed with HGSOC, borderline ovarian tumors, or benign ovarian disease. Through a multi-step statistical procedure combining univariate and multivariate logistic regression models, we aimed to identify CpG sites of interest. RESULTS AND CONCLUSIONS We discovered 21 DMPs and developed a predictive model validated in two independent cohorts. Our model, using a distance-to-centroid approach, accurately distinguished between benign and malignant disease. This model can potentially be used in other types of sample material. Moreover, the strategy of the model development and validation can also be used in other disease contexts for diagnostic purposes.
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Affiliation(s)
| | - Edyta Biskup
- Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Colm J O'Rourke
- Biotech Research & Innovation Centre, Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie L Hentze
- Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Jesper B Andersen
- Biotech Research & Innovation Centre, Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Claus Høgdall
- Department of Gynecology, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Estrid V Høgdall
- Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
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13
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Hasan Z, Singh M, Singh J, Chellani G, Nisam I, Rakheja G, Jain S, Khurana N, Mandal S, Rathi AK, Mala YM, Batra R. Fine Needle Aspiration Cytology of Ovarian Tumors With Histopathological Correlation: A Revisit to Borderline Category. J Cytol 2024; 41:229-235. [PMID: 39735366 PMCID: PMC11676087 DOI: 10.4103/joc.joc_196_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/22/2024] [Accepted: 09/20/2024] [Indexed: 12/31/2024] Open
Abstract
Background Borderline ovarian tumors (BOTs) comprise 15%-20% of all ovarian epithelial malignancies. The majority of them are serous tumors followed by mucinous tumors. Pre-operative cytological diagnosis plays an important role with histopathology being the gold standard. The present study aimed to assess the sensitivity, specificity, and diagnostic accuracy of cytology in the diagnosis of epithelial ovarian tumors with special emphasis on the cytologically borderline category. Materials and Methods The present study was conducted in our institute over five years from January 2017 to December 2022. This was a retrospective study and included 92 patients with ovarian masses who were subjected to ultrasound-guided fine needle aspiration (FNA) as a preliminary diagnostic procedure. Cytology smears were examined and categorized as benign, borderline, and malignant. The sensitivity, specificity, and diagnostic accuracy were assessed considering histopathology as the gold standard. Results In the present study, 92 ovarian FNA cytology were performed. Aspirates were adequate in all but 10 cases. Out of 82 cases, 75 were epithelial tumors. Twelve cases of BOTs were compiled and cytological findings were assessed. Conclusion To conclude, diagnosis of BOTs on cytology is difficult, however, aspiration from multiple sites from the lesion, critical cytomorphological assessment, and cell-block preparation with immunocytochemistry/immunohistochemistry can overcome the pitfalls.
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Affiliation(s)
- Zoya Hasan
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Meeta Singh
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Jyoti Singh
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Gautam Chellani
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Irfana Nisam
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Garima Rakheja
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Shyama Jain
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Shramana Mandal
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Arun K Rathi
- Department of Radiotherapy, Maulana Azad Medical College, New Delhi, India
| | - Yedla M Mala
- Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Radhika Batra
- Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India
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14
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Ritonja JA, Madathil S, Nicolau B, L'Espérance K, Ho V, Abrahamowicz M, Koushik A. Body fatness across the adult life course and ovarian cancer risk. Eur J Epidemiol 2024; 39:1139-1149. [PMID: 39404972 DOI: 10.1007/s10654-024-01161-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 09/28/2024] [Indexed: 11/27/2024]
Abstract
Excess body fatness in late adulthood has been observed to increase ovarian cancer risk, but the association is relatively weak. Body fatness can change over time, and timing may differently influence risk. We used a life course epidemiology approach to identify whether the relation between body fatness and ovarian cancer risk is best described by a critical period, accumulation or sensitive period hypothesis. In a population-based case-control study of ovarian cancer in Montreal, Canada (2011-16), data on body mass index (BMI) at each decade starting at age 20 was available. Among 363 cases and 707 controls aged ≥ 50 years, we used a Bayesian relevant life course exposure model to estimate the relative importance of BMI for three pre-specified periods across the adult life course, i.e., early childbearing years, late childbearing years, and peri/postmenopause, on ovarian cancer risk. The accumulation hypothesis best described BMI in relation to ovarian cancer overall, with an odds ratio (OR) for the lifetime effect of BMI (per 5 kg/m2 increase) of 1.10 (95% credible interval [CrI]: 0.90-1.35). For invasive ovarian cancer, the OR (95% CrI) for the lifetime effect was 1.16 (0.92-1.48), with BMI during early childbearing years showing the highest relative importance, suggesting this may be a sensitive period. For borderline cancer, the lifetime effect OR was not strongly supportive of an association (OR: 0.90, 95% CrI: 0.53-1.32). The results suggest that a sensitive period of early childbearing years is a candidate hypothesis for further investigation.
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Affiliation(s)
- Jennifer A Ritonja
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- St. Mary's Research Centre, Montreal, QC, Canada
| | - Sreenath Madathil
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Belinda Nicolau
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Kevin L'Espérance
- Université de Montréal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC, Canada
| | - Vikki Ho
- Université de Montréal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC, Canada
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Anita Koushik
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
- St. Mary's Research Centre, Montreal, QC, Canada.
- Université de Montréal Hospital Research Centre (CRCHUM), Montréal, QC, Canada.
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15
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van der Eerden B, de Rooij BH, Schouten LJ, Boll D, van Hamont D, Vos MC, Ezendam NPM. Quality of life among borderline ovarian tumor survivors: A comparison with survivors of early-stage ovarian cancer and a cancer-free population: A cross-sectional population-based PROFILES study. Gynecol Oncol 2024; 189:111-118. [PMID: 39096588 DOI: 10.1016/j.ygyno.2024.07.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVE This study assessed the health-related quality of life (HRQo) of women surviving a borderline ovarian tumor (BOT) in comparison with early-stage ovarian cancer survivors treated surgically alone and with a matched cancer-free population. METHODS Survivors of BOT and ovarian cancer were invited in two Dutch cross-sectional, population-based studies. Ovarian cancer survivors with tumor stage I who were treated surgically only were included. A random sample from the cancer-free population was matched on sex, age and education to the sample of BOT survivors. The EORTC QLQ-C30 (version 3.0) and the EORTC QLQ-OV28 were completed by the cancer-free population and the BOT and ovarian cancer survivors in study 1 and 2. The Hospital Anxiety and Depression Scale (HADS) was only completed by the cancer-free population and the survivors of BOT and ovarian cancer in study 1. BOT survivors were compared to early-stage ovarian cancer survivors and the general population using linear regression analyses and effect sizes regarding clinical importance. RESULTS 83 BOT (42%), 88 early-stage ovarian cancer survivors (52%), and 82 women from the general population were included. In most HRQoL domains, BOT survivors were not significantly different from early-stage ovarian cancer survivors and the cancer-free population, except that BOT survivors reported significantly less insomnia than early-stage ovarian cancer survivors and more dyspnea than the cancer-free population (small clinical difference). CONCLUSION In general, BOT survivors' HRQoL lies between the HRQoL of early-stage ovarian cancer survivors and of the cancer-free population, but clinical effect sizes between the groups were mostly only trivial.
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Affiliation(s)
- Babette van der Eerden
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Department of Epidemiology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, the Netherlands
| | - Belle H de Rooij
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Leo J Schouten
- Department of Epidemiology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, the Netherlands
| | - Dorry Boll
- Department of Gynecology, Catharina Hospital, Eindhoven, the Netherlands
| | - Dennis van Hamont
- Department of Gynecology, Amphia Hospital, Breda and Oosterhout, the Netherlands
| | - M Caroline Vos
- Department of Obstetrics and Gynecology, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, the Netherlands
| | - Nicole P M Ezendam
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
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16
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Wang R, Liu H, Tang J, Geng J. The application value of two-dimensional ultrasound combined with contrast-enhanced ultrasound in the differential diagnosis of benign, borderline, and malignant ovarian epithelial tumors. J Ovarian Res 2024; 17:191. [PMID: 39342318 PMCID: PMC11438069 DOI: 10.1186/s13048-024-01514-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 09/11/2024] [Indexed: 10/01/2024] Open
Abstract
OBJECTIVE The aim of this study was to explore the clinical application value of two-dimensional ultrasound (2D-US) combined with contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of benign, borderline ovarian tumors (BOTs), and malignant ovarian epithelial tumors (OETs). METHODS The clinical data of 108 patients who underwent surgery for pathologically confirmed of OETs at Peking University People's Hospital between December 2018 and November 2023 were retrospectively studied. The diagnostic value of 2D-US combined with CEUS for diagnosing OETs was analyzed using chi-square tests, receiver operating characteristic (ROC) curves, and random forest models. RESULTS Among the 108 cases of OETs, 23 were benign, 34 were BOTs, and 51 were malignant. Chi-square tests confirmed that the perfusion pattern of the contrast agent plays an important role in the differential diagnosis of OETs. Compared with those in the benign group, the BOTs were not significantly different in terms of perfusion phase and enhancement intensity, but the regression time of the BOTs was earlier (P < 0.05). Compared with the BOTs, the malignant tumors group showed earlier perfusion and higher enhancement intensity, with no significant difference in regression time. The ROC curve results indicated that the combined diagnostic efficiency of 2D-US and CEUS in distinguishing OETs was significantly higher than that of a single diagnostic technique in terms of sensitivity, specificity, accuracy, and AUC. The random forest model results revealed that among the various parameters used in the differential diagnosis of OETs, the perfusion pattern was the most significant factor. CONCLUSION 2D-US combined with CEUS helps improve the differential diagnostic efficiency for benign, BOTs, and malignant OETs.
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Affiliation(s)
- Rongli Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, China
| | - Huiping Liu
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, China
| | - Jun Tang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, China
| | - Jing Geng
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, China.
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17
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Papaetis GS, Kazakos IP, Constantinou PG, Evagorou VK, Karvounaris SA, Mikellidis KC. Musculoskeletal Pain and Right Leg Paresthesia Revealed as Large Ovarian Mucinous Cystadenoma: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e945083. [PMID: 39289860 PMCID: PMC11416133 DOI: 10.12659/ajcr.945083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/05/2024] [Accepted: 07/29/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Epithelial neoplasms are the most common and heterogenous group of ovarian tumors. Approximately 10-15% are primary ovarian mucinous neoplasms. Almost 80% of these consist of benign mucinous neoplasms, while the rest are borderline neoplasms, non-invasive (intraepithelial and intraglandular) carcinomas, and invasive carcinomas. Small ovarian cystadenomas are generally asymptomatic and are mainly found incidentally during an ultrasound examination for another gynecologic disorder. As their size increases, nonspecific symptoms and clinical signs develop as a result of mass effect to adjacent structures or because of tumor torsion. The main clinical symptoms are abdominal and/or pelvic pain, fullness, and discomfort. Large cystadenomas have also been associated with nausea and vomiting, urinary problems, persistent cough, back pain, metrorrhagia, and feminization. CASE REPORT We report a case of a 31-year-old woman with a body mass index of 39 who presented with increasing sacrococcygeal pain and right leg paresthesia over a 2-year period. She was treated for possible musculoskeletal and spine problems. She was finally diagnosed with a large right ovarian mucinous cystadenoma expanding in the sacrococcygeal region. She was successfully treated with complete excision of the tumor and achieved complete remission of all her symptoms. CONCLUSIONS Large ovarian mucinous cystadenomas, which develop in the sacrococcygeal region, can lead to symptoms that mimic musculoskeletal and spine problems. Early diagnosis is of great importance towards the goal of implementing proper therapeutic approaches and achieve complete remission of all clinical symptoms.
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Affiliation(s)
- Georgios S. Papaetis
- Internal Medicine and Diabetes Clinic, K.M.P. THERAPIS Paphos Medical Center, Paphos, Cyprus
- C.D.A. College, Paphos, Cyprus
| | - Ioannis P. Kazakos
- Obstetrics and Gynecology Clinic, Ygia Polyclinic Private Hospital, Limassol, Cyprus
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Barlow M, Down L, Mounce LTA, Funston G, Merriel SWD, Watson J, Abel G, Kirkland L, Martins T, Bailey SER. The diagnostic performance of CA-125 for the detection of ovarian cancer in women from different ethnic groups: a cohort study of English primary care data. J Ovarian Res 2024; 17:173. [PMID: 39187847 PMCID: PMC11346194 DOI: 10.1186/s13048-024-01490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 08/09/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND CA-125 testing is a recommended first line investigation for women presenting with possible symptoms of ovarian cancer in English primary care, to help determine whether further investigation for ovarian cancer is needed. It is currently not known how well the CA-125 test performs in ovarian cancer detection for patients from different ethnic groups. METHODS A retrospective cohort study utilising English primary care data linked to the national cancer registry was undertaken. Women aged ≥ 40 years with a CA-125 test between 2010 and 2017 were included. Logistic regression predicted one-year ovarian cancer incidence by ethnicity, adjusting for age, deprivation status, and comorbidity score. The estimated incidence of ovarian cancer by CA-125 level was modelled for each ethnic group using restricted cubic splines. RESULTS The diagnostic performance of CA-125 differed for women from different ethnicities. In an unadjusted analysis, predicted CA-125 levels for Asian and Black women were higher than White women at corresponding probabilities of ovarian cancer. The higher PPVs for White women compared to Asian or Black women were eliminated by inclusion of covariates. CONCLUSION The introduction of ethnicity-specific thresholds may increase the specificity and PPVs of CA-125 in ovarian cancer detection at the expense of sensitivity, particularly for Asian and Black women. As such, we cannot recommend the use of ethnicity-specific thresholds for CA-125.
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Affiliation(s)
- Melissa Barlow
- Department of Health and Community Sciences, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Liz Down
- Department of Health and Community Sciences, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Luke T A Mounce
- Department of Health and Community Sciences, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Garth Funston
- Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Samuel W D Merriel
- Centre for Primary Care & Health Services Research, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Jessica Watson
- Centre for Academic Primary Care (CAPC), Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Gary Abel
- Department of Health and Community Sciences, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Lucy Kirkland
- Department of Health and Community Sciences, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Tanimola Martins
- Department of Health and Community Sciences, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Sarah E R Bailey
- Department of Health and Community Sciences, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK
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19
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Sadlecki P, Walentowicz-Sadlecka M. Molecular landscape of borderline ovarian tumours: A systematic review. Open Med (Wars) 2024; 19:20240976. [PMID: 38859878 PMCID: PMC11163159 DOI: 10.1515/med-2024-0976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/09/2024] [Accepted: 05/05/2024] [Indexed: 06/12/2024] Open
Abstract
Borderline ovarian tumours (BOTs) show intriguing characteristics distinguishing them from other ovarian tumours. The aim of the systematic review was to analyse the spectrum of molecular changes found in BOTs and discuss their significance in the context of the overall therapeutic approach. The systematic review included articles published between 2000 and 2023 in the databases: PubMed, EMBASE, and Cochrane. After a detailed analysis of the available publications, we qualified for the systematic review: 28 publications on proto-oncogenes: BRAF, KRAS, NRAS, ERBB2, and PIK3CA, 20 publications on tumour suppressor genes: BRCA1/2, ARID1A, CHEK2, PTEN, 4 on adhesion molecules: CADM1, 8 on proteins: B-catenin, claudin-1, and 5 on glycoproteins: E-Cadherin. In addition, in the further part of the systematic review, we included eight publications on microsatellite instability and three describing loss of heterozygosity in BOT. Molecular changes found in BOTs can vary on a case-by-case basis, identifying carcinogenic mutations through molecular analysis and developing targeted therapies represent significant advancements in the diagnosis and treatment of ovarian malignancies. Molecular studies have contributed significantly to our understanding of BOT pathogenesis, but substantial research is still required to elucidate the relationship between ovarian neoplasms and extraneous disease, identify accurate prognostic indicators, and develop targeted therapeutic approaches.
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Affiliation(s)
- Pawel Sadlecki
- Medical Department, University of Science and Technology, Bydgoszcz, Poland
- Department of Obstetrics and Gynecology, Regional Polyclinical Hospital, Grudziadz, Poland
| | - Malgorzata Walentowicz-Sadlecka
- Medical Department, University of Science and Technology, Bydgoszcz, Poland
- Department of Obstetrics and Gynecology, Regional Polyclinical Hospital, Grudziadz, Poland
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20
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Onuzo CN, Gordon AS, Amoatwo JKA, Kuti CK, Taylor P, Sefogah PE. A giant 25 litre volume ovarian cystic mucinous borderline ovarian tumour with intraepithelial carcinoma in a 24-year-old nulliparous woman: Case report. Int J Surg Case Rep 2024; 119:109732. [PMID: 38754159 PMCID: PMC11109311 DOI: 10.1016/j.ijscr.2024.109732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Giant ovarian cysts are rare and usually pose significant diagnostic challenges especially in adolescents and young adults. There is limited report of such cases reported in existing literature with hardly any cases published from the Sub-Sharan African region. CASE PRESENTATION We present the case of a 24-year-old young woman who reported to our gynaecology clinic on the 23rd of January 2023 with a year's history of a progressively increasing abdominopelvic mass. She was successfully managed surgically and made smooth recovery. CLINICAL DISCUSSION Based on the history and examination findings, confirmed the diagnosis clinically with abdomino-pelvic ultrasound scan, removed the tumour surgically and undertook histopathological studies to confirm a benign disease. To the best of our knowledge, our successful management of this patient is the first case of such a huge borderline ovarian tumour reported in Ghana and the Sub-Saharan African region to inform clinicians on safe surgical management in our context. CONCLUSION Our successful management of this giant mucinous BOT reiterates the fact that in the absence of precise prognostic marker of malignancy, clinicians should always balance the oncologic safety of the patient against less radical treatment modality.
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Affiliation(s)
- Chibuikem N Onuzo
- Department of Obstetrics and Gynaecology, University of Ghana Medical Center, Legon, Accra, Ghana
| | - Afua S Gordon
- Department of Obstetrics and Gynaecology, University of Ghana Medical Center, Legon, Accra, Ghana
| | - Jacob K A Amoatwo
- Department of Obstetrics and Gynaecology, University of Ghana Medical Center, Legon, Accra, Ghana
| | - Christiana K Kuti
- Department of Obstetrics and Gynaecology, University of Ghana Medical Center, Legon, Accra, Ghana
| | - Peter Taylor
- Department of Obstetrics and Gynaecology, University of Ghana Medical Center, Legon, Accra, Ghana
| | - Promise E Sefogah
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Korle Bu, Accra, Ghana.
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21
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Kristensen AK, Frandsen CLB, Nøhr B, Viuff JH, Hargreave M, Frederiksen K, Kjær SK, Jensen A. Risk of borderline ovarian tumors after fertility treatment - Results from a Danish cohort of infertile women. Gynecol Oncol 2024; 185:108-115. [PMID: 38382167 DOI: 10.1016/j.ygyno.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/29/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Results from previous studies examining the association between fertility treatment and borderline ovarian tumors are inconsistent. The aim of this study was to investigate the association between fertility treatment and borderline ovarian tumors in a cohort of infertile women. METHODS This cohort study was based on the Danish Infertility Cohort and included all infertile women aged 20-45 years living in Denmark between 1 January 1995 and 31 December 2017 (n = 146,891). Information on use of fertility drugs, borderline ovarian tumors and cancer diagnoses, covariates, emigration, and vital status was obtained by linkage to national registers. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) with adjustment for potential confounders for overall borderline ovarian tumors and for serous- and mucinous borderline ovarian tumors separately. RESULTS During a median 11.3 years of follow-up, 144 women developed a borderline ovarian tumor. No marked associations between ever use of clomiphene citrate, gonadotropins, gonadotropin-releasing hormone receptor modulators, human chorionic gonadotropin or progesterone and borderline ovarian tumors were observed, neither overall nor for serous and mucinous borderline ovarian tumors analysed separately. Further, no clear associations with borderline ovarian tumors were found according to cumulative dose, time since first use or parity status for any fertility drugs. CONCLUSIONS No marked associations between use of fertility drugs and borderline ovarian tumors were observed. However, the cohort's relatively young age at end of follow-up emphasizes the importance of extending the follow-up period for women who have used fertility drugs.
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Affiliation(s)
| | - Clarissa Lima Brown Frandsen
- Virus, Lifestyle and Genes, Danish Cancer Institute, 2100 Copenhagen, Denmark; Department of Obstetrics and Gynecology, Herlev University Hospital, 2730 Herlev, Denmark
| | - Bugge Nøhr
- Virus, Lifestyle and Genes, Danish Cancer Institute, 2100 Copenhagen, Denmark; Department of Obstetrics and Gynecology, Herlev University Hospital, 2730 Herlev, Denmark
| | - Jakob Hansen Viuff
- Diet, Cancer and Health, Danish Cancer Institute, 2100 Copenhagen, Denmark
| | - Marie Hargreave
- Virus, Lifestyle and Genes, Danish Cancer Institute, 2100 Copenhagen, Denmark
| | - Kirsten Frederiksen
- Statistics and Data Analysis, Danish Cancer Institute, 2100 Copenhagen, Denmark
| | - Susanne K Kjær
- Virus, Lifestyle and Genes, Danish Cancer Institute, 2100 Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Institute, 2100 Copenhagen, Denmark.
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22
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Ergun-Longmire B, Greydanus DE. Ovarian tumors in the pediatric population: An update. Dis Mon 2024; 70:101691. [PMID: 38281826 DOI: 10.1016/j.disamonth.2024.101691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Research reveals that 1% of neoplasms in females under 17 years of age are ovarian neoplasms and though usually benign, malignant tumors may occur in the pediatric age group. This review considers various current concepts of these tumors including the epidemiology, risk factors, clinical presentations, diagnosis, differential diagnosis, and treatment options including the need to provide fertility-sparing surgery as well as their potential impacts on the psychological well-being of children and adolescents. We gathered data from the published articles ranging from studies, meta-analyses, retrospective studies, and reviews. We focused on the articles published in English between January 1, 2000, and August 31, 2023. Only a few articles published prior to 2000 were included for historical perspective.
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Affiliation(s)
- Berrin Ergun-Longmire
- Department of Pediatric and Adolescent Medicine, Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA.
| | - Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
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23
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Mitchell S, Ramajayan T, Sayasneh A. Borderline tumour recurrence: how quickly does the tumour grow? BMJ Case Rep 2024; 17:e259501. [PMID: 38724214 PMCID: PMC11085964 DOI: 10.1136/bcr-2023-259501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
This abstract describes a case of the growth of a serous borderline tumour recurrence and cyst to papillary projection ratio with associated ultrasound images. The aetiology, presentation and management of such cases are explored and compared to the literature.
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Affiliation(s)
- Sian Mitchell
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Thushanee Ramajayan
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ahmad Sayasneh
- Gynaecological Oncology, Guy's and St Thomas's NHS Foundation Trust, London, UK
- School of Life Course Sciences, Faculty of Life Sciences and Medicine, St Thomas Hospital, Westminster Bridge Road, London, UK
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24
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Pence S, Christiansen A, George E. Giant Mucinous Borderline Ovarian Tumor Presenting Alongside Perforated Peptic Ulcers. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102114. [PMID: 37061221 DOI: 10.1016/j.jogc.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Sydney Pence
- Ohio University Heritage College of Osteopathic Medicine Cleveland Campus, Warrensville Heights, OH
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25
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Bhardwaj S, Banet N, Gaston EC. Moderately-differentiated Ovarian Sertoli-Leydig Cell Tumor With a Concurrent Serous Borderline Tumor in a 16-year-old Girl. Int J Gynecol Pathol 2024; 43:140-144. [PMID: 37562020 DOI: 10.1097/pgp.0000000000000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Sertoli-Leydig cell tumors (SLCT) are rare tumors of the ovary with a peak incidence in the second to third decade of life. Serous borderline tumors (SBT) are epithelial ovarian neoplasms which occur at a median age of 50 years. A co-occurrence of SLCT and SBT has not yet been reported. Here, we describe a case of a 16-year-old girl who presented with irregular menses, virilization, and an abdominopelvic mass. The mass was surgically removed and an intraoperative consultation revealed an 18.5 cm solid and cystic ovarian mass with the presence of co-existing SLCT and SBT. The diagnosis was confirmed on permanent sections after extensive sampling and immunohistochemical stains. The SLCT showed positive staining for calretinin, inhibin, CD99, and androgen receptor. MART-1 immunostain highlighted the Leydig cells. The SBT showed classic features including hierarchically branching papillae lined by stratified serous epithelium. This pediatric case is the first reported case of a Sertoli-Leydig cell tumor arising in association with a serous borderline tumor.
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26
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Ko ME, Lin YH, Huang KJ, Chang WC, Sheu BC. Fertility and Pregnancy Outcomes after Fertility-Sparing Surgery for Early-Stage Borderline Ovarian Tumors and Epithelial Ovarian Cancer: A Single-Center Study. Cancers (Basel) 2023; 15:5327. [PMID: 38001586 PMCID: PMC10670285 DOI: 10.3390/cancers15225327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
This study examined treatment outcomes, including preserved fertility, menstrual regularity, and pregnancy outcomes, in patients with stage I epithelial ovarian cancer (EOC) or borderline ovarian tumors (BOTs) who underwent fertility-sparing surgery (FSS). Patients with stage I EOC and BOTs who were aged 18-45 years and underwent FSS between 2007 and 2022 were retrospectively reviewed. Significant differences between various subgroups in terms of disease recurrence, menstrual irregularity due to the disease, and pregnancy outcomes were analyzed. A total of 71 patients with BOTs and 33 patients with EOC were included. In the BOT group, the median age was 30 (range, 19-44) years. Recurrence occurred in eight patients, with one case exhibiting a malignant transformation into mucinous EOC. Among the 35 married patients with BOTs, 20 successfully conceived, resulting in 23 live births and 3 spontaneous abortions. A higher pregnancy rate was observed in those without prior childbirth (82.4%) than in those who had prior childbirth (33.3%). In the EOC group, the median age was 34 (range, 22-42) years. Recurrence occurred in one patient. Menstrual regularity was maintained in 69.7% of the patients. Among the 14 married patients in this group, 12 achieved a total of 15 pregnancies (including 2 twin pregnancies), 16 live births, and 1 spontaneous abortion. The results of the study confirmed that FSS is a favorable surgical option for young women with early-stage BOTs or EOC who wish to preserve their fertility. However, additional investigations are needed to validate these findings.
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Affiliation(s)
- Mu-En Ko
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan; (M.-E.K.); (K.-J.H.)
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 100, Taiwan; (Y.-H.L.); (B.-C.S.)
| | - Yi-Heng Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 100, Taiwan; (Y.-H.L.); (B.-C.S.)
| | - Kuan-Ju Huang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan; (M.-E.K.); (K.-J.H.)
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 100, Taiwan; (Y.-H.L.); (B.-C.S.)
| | - Wen-Chun Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 100, Taiwan; (Y.-H.L.); (B.-C.S.)
| | - Bor-Ching Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 100, Taiwan; (Y.-H.L.); (B.-C.S.)
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Nunes SC, Sousa J, Silva F, Silveira M, Guimarães A, Serpa J, Félix A, Gonçalves LG. Peripheral Blood Serum NMR Metabolomics Is a Powerful Tool to Discriminate Benign and Malignant Ovarian Tumors. Metabolites 2023; 13:989. [PMID: 37755269 PMCID: PMC10537270 DOI: 10.3390/metabo13090989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
Ovarian cancer is the major cause of death from gynecological cancer and the third most common gynecological malignancy worldwide. Despite a slight improvement in the overall survival of ovarian carcinoma patients in recent decades, the cure rate has not improved. This is mainly due to late diagnosis and resistance to therapy. It is therefore urgent to develop effective methods for early detection and prognosis. We hypothesized that, besides being able to distinguish serum samples of patients with ovarian cancer from those of patients with benign ovarian tumors, 1H-NMR metabolomics analysis might be able to predict the malignant potential of tumors. For this, serum 1H-NMR metabolomics analyses were performed, including patients with malignant, benign and borderline ovarian tumors. The serum metabolic profiles were analyzed by multivariate statistical analysis, including principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) methods. A metabolic profile associated with ovarian malignant tumors was defined, in which lactate, 3-hydroxybutyrate and acetone were increased and acetate, histidine, valine and methanol were decreased. Our data support the use of 1H-NMR metabolomics analysis as a screening method for ovarian cancer detection and might be useful for predicting the malignant potential of borderline tumors.
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Affiliation(s)
- Sofia C. Nunes
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (S.C.N.); (J.S.); (A.F.)
- Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023 Lisbon, Portugal
| | - Joana Sousa
- Instituto de Tecnologia Química e Biológica António Xavier (ITQB NOVA), Avenida da República (EAN), 2780-157 Oeiras, Portugal
| | - Fernanda Silva
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (S.C.N.); (J.S.); (A.F.)
- Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023 Lisbon, Portugal
| | - Margarida Silveira
- Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023 Lisbon, Portugal
| | - António Guimarães
- Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023 Lisbon, Portugal
| | - Jacinta Serpa
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (S.C.N.); (J.S.); (A.F.)
- Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023 Lisbon, Portugal
| | - Ana Félix
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (S.C.N.); (J.S.); (A.F.)
- Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023 Lisbon, Portugal
| | - Luís G. Gonçalves
- Instituto de Tecnologia Química e Biológica António Xavier (ITQB NOVA), Avenida da República (EAN), 2780-157 Oeiras, Portugal
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28
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Pecorino B, Laganà AS, Mereu L, Ferrara M, Carrara G, Etrusco A, Di Donna MC, Chiantera V, Cucinella G, Barra F, Török P, Scollo P. Evaluation of Borderline Ovarian Tumor Recurrence Rate after Surgery with or without Fertility-Sparing Approach: Results of a Retrospective Analysis. Healthcare (Basel) 2023; 11:1922. [PMID: 37444757 PMCID: PMC10341047 DOI: 10.3390/healthcare11131922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/21/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
Borderline ovarian tumors (BOTs) comprise 15-20% of primary ovarian neoplasms and represent an independent disease entity among epithelial ovarian cancers. The present study (Clinical Trial ID: NCT05791838) aimed to report a retrospective analysis of the management and outcomes of 86 consecutive BOTs patients, 54 of which were at a reproductive age. All patients with BOTs undergoing surgical treatment from January 2010 to December 2017 were included. Data were retrospectively reviewed. High levels of Ca-125 were observed in 25.6% of the FIGO stage I patients and 58.3% of the advanced disease patients. Fertility-sparing surgery and comprehensive surgical staging were performed in 36.7% and 49.3% of the patients, respectively. Laparotomy was the most frequent surgical approach (65.1%). The most common diagnosis at frozen sections was serous BOT (50.6%). Serous BOTs have significantly smaller tumor diameters than mucinous BOTs (p < 0.0001). The mean postoperative follow-up was 29.8 months (range 6-87 months). Three patients experienced a recurrence, with an overall recurrence rate of 3.5% (10% considering only the patients who underwent fertility-sparing treatment). BOTs have low recurrence rates, with excellent prognosis. Surgery with proper staging is the main treatment. Conservative surgery is a valid option for women with reproductive potential.
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Affiliation(s)
- Basilio Pecorino
- Maternal and Child Department, Gynecology and Obstetrics Cannizzaro Hospital, Kore University of Enna, 94100 Enna, Italy; (B.P.); (M.F.); (G.C.); (P.S.)
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy; (A.E.); (M.C.D.D.); (V.C.); (G.C.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Liliana Mereu
- Division of Obstetrics and Gynecology, Department of General Surgery and Medical-Surgical Specialism, University of Catania, 95123 Catania, Italy;
| | - Martina Ferrara
- Maternal and Child Department, Gynecology and Obstetrics Cannizzaro Hospital, Kore University of Enna, 94100 Enna, Italy; (B.P.); (M.F.); (G.C.); (P.S.)
| | - Grazia Carrara
- Maternal and Child Department, Gynecology and Obstetrics Cannizzaro Hospital, Kore University of Enna, 94100 Enna, Italy; (B.P.); (M.F.); (G.C.); (P.S.)
| | - Andrea Etrusco
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy; (A.E.); (M.C.D.D.); (V.C.); (G.C.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Mariano Catello Di Donna
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy; (A.E.); (M.C.D.D.); (V.C.); (G.C.)
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90133 Palermo, Italy
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy; (A.E.); (M.C.D.D.); (V.C.); (G.C.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Giuseppe Cucinella
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy; (A.E.); (M.C.D.D.); (V.C.); (G.C.)
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90133 Palermo, Italy
| | - Fabio Barra
- Unit of Obstetrics and Gynecology, P.O. “Ospedale del Tigullio”-ASL4, Metropolitan Area of Genoa, 16043 Genoa, Italy;
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy
| | - Péter Török
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Paolo Scollo
- Maternal and Child Department, Gynecology and Obstetrics Cannizzaro Hospital, Kore University of Enna, 94100 Enna, Italy; (B.P.); (M.F.); (G.C.); (P.S.)
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Ginnavaram V, Vasugi A, Sundaram S. Immunohistochemical Evaluation of Notch1 in Ovarian Tumours and Its Prognostic Implications. Cureus 2023; 15:e40830. [PMID: 37489207 PMCID: PMC10363259 DOI: 10.7759/cureus.40830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Ovarian cancer is the fifth most common malignancy among women and the second most common gynaecological malignancy. Surface epithelial ovarian tumours constitute two-thirds of all ovarian tumours. Most high-grade serous carcinoma patients gain an initial complete response but eventually succumb to relapse and death leaving the overall survival grim. Therefore, new regimens targeting the pathways involved in metastasis and chemoresistance are essential for the development of more effective therapies. Notch signalling is one of the pleiotropic signalling pathways that plays a key role in differentiation and tissue morphogenesis. It has been observed that this Notch signalling pathway is seen to be deregulated in various cancers. It is thought to have an oncogenic role in ovarian cancer. Our objective in this study is to evaluate the immunohistochemical expression pattern of Notch1 in surface epithelial ovarian tumours and its correlation with the clinicopathological profile. METHODS This study includes a total of 100 cases of borderline and malignant surface epithelial ovarian tumours. Clinical data of the patients were obtained from the medical records section. HPE slides were examined and one representative paraffin block was selected for each patient. IHC of Notch1 was performed and analyzed. The staining pattern for Notch1 was calculated using the Q score. RESULTS Immunohistochemistry (IHC) evaluation of Notch1 in surface epithelial ovarian tumours in this study showed an increased intensity of Notch1 staining in high-grade serous malignant tumours. The grading and staging of tumours were compared with Notch1 expression. Statistical analysis was performed using Spearman Rank order correlation analysis. There was a significant correlation (0.01 level, two-tailed) between the grading and staging of ovarian tumours and Notch1 expression. CONCLUSION Assessing Notch1 expression in ovarian cancer by IHC is a useful tool in view of its clinical applications, development of targeted therapies and as a marker of prognosis. The intensity of the Notch1 stain appears to be directly proportional to the grade of tumour. This may offer a potential targeted therapy against the Notch signalling pathway in tumours that strongly express Notch1.
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Affiliation(s)
- Varsha Ginnavaram
- Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Arumugam Vasugi
- Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Sandhya Sundaram
- Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Capozzi VA, Scarpelli E, Monfardini L, Mandato VD, Merisio C, Uccella S, Sozzi G, Ceccaroni M, Chiantera V, Giordano G, Della Corte L, Conte C, Cianci S, Ghi T, Berretta R. Do Exophytic and Endophytic Patterns in Borderline Ovarian Tumors Have Different Prognostic Implications? A Large Multicentric Experience. J Clin Med 2023; 12:jcm12103544. [PMID: 37240649 DOI: 10.3390/jcm12103544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Borderline ovarian tumor (BOT) accounts for 15-20% of all epithelial ovarian tumors. Concerns have arisen about the clinical and prognostic implications of BOT with exophytic growth patterns. We retrospectively reviewed all cases of BOT patients surgically treated from 2015 to 2020. Patients were divided into an endophytic pattern (with intracystic tumor growth and intact ovarian capsule) and an exophytic pattern (with tumor growth outside the ovarian capsule) group. Among the 254 patients recruited, 229 met the inclusion criteria, and of these, 169 (73.8%) belonged to the endophytic group. The endophytic group showed more commonly an early FIGO stage than the exophytic group (100.0% vs. 66.7%, p < 0.001). Furthermore, tumor cells in peritoneal washing (20.0% vs. 0.6%, p < 0.001), elevated Ca125 levels (51.7% vs. 31.4%, p = 0.003), peritoneal implants (0 vs. 18.3%, p < 0.001), and invasive peritoneal implants (0 vs. 5%, p = 0.003) were more frequently observed in the exophytic group. The survival analysis showed 15 (6.6%) total recurrences, 9 (5.3%) in the endophytic and 6 (10.0%) patients in the exophytic group (p = 0.213). At multivariable analysis, age (p = 0.001), FIGO stage (p = 0.002), fertility-sparing surgery (p = 0.001), invasive implants (p = 0.042), and tumor spillage (p = 0.031) appeared significantly associated with recurrence. Endophytic and exophytic patterns in borderline ovarian tumors show superimposable recurrence rates and disease-free survival.
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Affiliation(s)
- Vito Andrea Capozzi
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Elisa Scarpelli
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Luciano Monfardini
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Vincenzo Dario Mandato
- Unit of Obstetrics and Gynecology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Carla Merisio
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37126 Verona, Italy
| | - Giulio Sozzi
- Department of Gynecologic Oncology, University of Palermo, 90127 Palermo, Italy
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynaecology, Gynaecologic Oncology, and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, Sacred Heart Hospital, 37024 Negrar, Italy
| | - Vito Chiantera
- Department of Gynecologic Oncology, University of Palermo, 90127 Palermo, Italy
| | - Giovanna Giordano
- Pathology Unit, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Carmine Conte
- Department of General Surgery and Medical-Surgical Specialties, Institute of Obstetrics and Gynecology, A.O.U. Policlinico Rodolico, San Marco, University of Catania, 95125 Catania, Italy
| | - Stefano Cianci
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adult and Childhood "G. Barresi", University of Messina, 98121 Messina, Italy
| | - Tullio Ghi
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Roberto Berretta
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
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Văduva CC, Constantinescu C, Ţenovici M, Boldeanu L, Istrate-Ofiţeru5 AM. Conservative treatment of borderline ovarian tumors: a retrospective study. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:143-150. [PMID: 37518870 PMCID: PMC10520401 DOI: 10.47162/rjme.64.2.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023]
Abstract
Borderline ovarian tumors (BOTs) are a group of tumors with histological aspects and intermediate biological evolution between benign and malignant tumors, characterized by epithelial proliferation, lack of stromal invasion and nuclear atypia. BOTs account for approximately 10-15% of epithelial ovarian carcinomas. The interest in fertility preservation is very important as most BOTs are diagnosed in patients less than 40 years of age. Since borderline tumors occur in young, fertile women, the therapeutic approach depends on both staging and the need to preserve ovarian function and fertility. Treatment of BOT is primarily surgical, but recently fertility-preserving surgery has become more important. If infertility persists, ovarian induction or in vitro fertilization (IVF) may be suggested in selected cases.
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Affiliation(s)
| | - Carmen Constantinescu
- Department of Obstetrics and Gynecology, Railroads Clinical Hospital, Craiova, Romania
| | - Mihaela Ţenovici
- Department of Pathology, Railroads Clinical Hospital, Craiova, Romania
| | - Lidia Boldeanu
- Department of Microbiology, University of Medicine and Pharmacy of Craiova, Romania
| | - Anca-Maria Istrate-Ofiţeru5
- Research Center for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, Romania
- Department of Histology, University of Medicine and Pharmacy of Craiova, Romania
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The Surgical Procedure in the Case of Ovarian Lesion in Neonate. J Pediatr Hematol Oncol 2023; 45:e126-e127. [PMID: 35398866 DOI: 10.1097/mph.0000000000002464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/04/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND In newborns and infants, ovarian lesions can be detected during ultrasound examination before or after birth. Malignant ovarian lesions account for <1% of malignancies in newborns. However, in case of doubt about the nature of the lesion, surgery with tissue collection for histopathologic evaluation should be considered with the absolute condition of fertility preservation. OBSERVATIONS The aim of this publication was to describe a case report of a 3-day-old infant who presented an ovarian lesion on postnatal ultrasound, with features suggesting a malignant nature of the ovary. In the described case, laparoscopy and mini-laparotomy were performed, torsion was excluded. The ovary was preserved, and histopathologic examination excluded the malignant nature of the lesion. CONCLUSION A detailed analysis of the clinical status, laboratory tests, and imaging studies is necessary before making a final decision on further therapeutic, especially surgical management of a newborn with an ovarian lesion.
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Lazurko C, Feigenberg T, Murphy J, Pulman K, Lennox G, Dube V, Zigras T. Identifying Borderline Ovarian Tumor Recurrence Using Routine Ultrasound Follow-Up. Cancers (Basel) 2022; 15:cancers15010073. [PMID: 36612070 PMCID: PMC9817930 DOI: 10.3390/cancers15010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/14/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Borderline ovarian tumors (BOTs) are non-invasive tumors frequently diagnosed in young patients. Surgical removal of the uterus, fallopian tubes, ovaries, and omentum is considered definitive management, however fertility-sparing approach is a recognized option. Surveillance is important due to known recurrence, but there is controversy over the effectiveness of follow-up modalities. The objective is to determine the efficacy of ultrasound screening in identifying tumor recurrence. This retrospective chart review evaluated all patients consulted and/or treated surgically at our institution from January 2015 to June 2020 diagnosed with BOT. Patients were excluded if concurrently diagnosed with another gynecologic malignancy, did not have yearly ultrasound follow-up, or were lost to follow-up. This study included 56 patients, 17 of whom underwent fertility preserving surgery. The overall rate of recurrence was 10.7%; with recurrence rates of 23.5% for the fertility preserving surgery population and 5.1% for the definitive surgery population. Ultrasound first identified 5 of the 6 (83.3%) recurrences. Overall time to recurrence was 51.5 months. In conclusion, recurrences were identified on routine ultrasound screening prior to symptom onset or detection via physical exam in 83.3% of cases. While the best modality of follow-up remains controversial, this review provides evidence supporting the use of routine ultrasound follow-up for early detection of BOT recurrence.
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Affiliation(s)
- Caitlin Lazurko
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Tomer Feigenberg
- Division of Gynecologic Oncology, Trillium Health Partners, Credit Valley Hospital, Mississauga, ON L5M 2N1, Canada
- Department of Obstetrics & Gynaecology, University of Toronto, Toronto, ON M5G 1E2, Canada
| | - Joan Murphy
- Division of Gynecologic Oncology, Trillium Health Partners, Credit Valley Hospital, Mississauga, ON L5M 2N1, Canada
| | - Kate Pulman
- Division of Gynecologic Oncology, Trillium Health Partners, Credit Valley Hospital, Mississauga, ON L5M 2N1, Canada
- Department of Obstetrics & Gynaecology, University of Toronto, Toronto, ON M5G 1E2, Canada
| | - Genevieve Lennox
- Division of Gynecologic Oncology, Trillium Health Partners, Credit Valley Hospital, Mississauga, ON L5M 2N1, Canada
- Department of Obstetrics & Gynaecology, University of Toronto, Toronto, ON M5G 1E2, Canada
| | - Valerie Dube
- Department of Pathology, Trillium Health Partners, Credit Valley Hospital, Mississauga, ON L5M 2N1, Canada
| | - Tiffany Zigras
- Division of Gynecologic Oncology, Trillium Health Partners, Credit Valley Hospital, Mississauga, ON L5M 2N1, Canada
- Department of Obstetrics & Gynaecology, University of Toronto, Toronto, ON M5G 1E2, Canada
- Correspondence: ; Tel.: +1-905-813-4024
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Clinicopathological Characteristics and Prognosis of 91 Patients with Seromucinous and Mucinous Borderline Ovarian Tumors: a Comparative Study. Reprod Sci 2022; 30:1927-1937. [DOI: 10.1007/s43032-022-01114-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/20/2022] [Indexed: 12/15/2022]
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Seromucinous and Mucinous Borderline Ovarian Tumors: We Need to Know More. Reprod Sci 2022; 30:1684-1685. [PMID: 36474132 DOI: 10.1007/s43032-022-01143-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
Borderline ovarian tumor (BOT) is a heterogeneous group of tumors characterized by low malignant potential and atypical proliferation, consisting of 15-20% of all primary ovarian neoplasm. Among BOTs, a subset has a high tendency of relapse probably due to inaccurate subtype stratification and unoptimized care. In this issue of Reproductive Sciences, Wu et al. compared two main BOT subtypes, seromucinous borderline (SMBOT), and mucinous borderline ovarian tumor (MBOT) across many aspects of their clinical pathological features, and identified significant different including tumor growth pattern, tumor sizes, recurrence rate, and the expression Mullerian markers. We reviewed similar work on features of BOT subtypes and highlighted the values added by this study. Future work could be validation with a larger sample size and multicenter design and the application of the identified difference in informing diagnosis and tailored treatment.
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Raimondo D, Raffone A, Scambia G, Maletta M, Lenzi J, Restaino S, Mascilini F, Trozzi R, Mauro J, Travaglino A, Driul L, Casadio P, Mollo A, Fagotti A, Vizzielli G, Seracchioli R. The impact of hysterectomy on oncological outcomes in postmenopausal patients with borderline ovarian tumors: A multicenter retrospective study. Front Oncol 2022; 12:1009341. [PMID: 36387131 PMCID: PMC9647053 DOI: 10.3389/fonc.2022.1009341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/12/2022] [Indexed: 11/21/2022] Open
Abstract
Data about the oncological outcomes in women with borderline ovarian tumor (BOT) undergoing uterine-sparing surgery without ovarian preservation are poor. We aimed to assess the oncological outcomes in women with BOT undergoing uterine-sparing surgery without ovarian preservation. A multi-center observational retrospective cohort study was performed including all consecutive postmenopausal patients who underwent surgical treatment for BOT at three tertiary level referral centers for gynecologic oncology from January 2005 to December 2016. Patients were divided into two groups for comparisons: patients undergoing hysterectomy (hysterectomy group) and patients undergoing uterine-sparing surgery (no hysterectomy group). Study outcomes were disease-free survival (DFS), overall survival (OS), disease-specific survival (DSS) and surgical complications rate. Ninety-eight patients were included: 44 in the hysterectomy group and 54 in the no hysterectomy group. The 5- and 10-year DFS rates were 97.7% (95% CI: 84.9-99.7) and 92.3% (95% CI: 69.7-98.2), in the hysterectomy group, and 86.8% (95% CI: 74.3-93.5) and 86.8% (95% CI: 74.3-93.5), in the no hysterectomy group, respectively, without significant differences (p=0.16). Hazard ratio for DFS was 0.26 (95% CI: 0.06-1.68) for the hysterectomy group. The 5- and 10-year OS rates were 100.0% (95% CI: -) and 100.0% (95% CI: -), in the hysterectomy group, and 98.2% (95% CI: 87.6-99.7) and 94.4% (95% CI: 77.7-98.7), in the no hysterectomy group, respectively, without significant differences (p=0.23). No significant difference in complication rate was reported among the groups (p=0.48). As hysterectomy appears to not impact survival outcomes of women with BOT, it might be avoided in the surgical staging.
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Affiliation(s)
- Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, Istituto di ricovero e cura a carattere scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Istituto di ricovero e cura a carattere scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giovanni Scambia
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Manuela Maletta
- Division of Gynaecology and Human Reproduction Physiopathology, Istituto di ricovero e cura a carattere scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Stefano Restaino
- Clinic of Obstetrics and Gynecology, “Santa Maria della Misericordia” University Hospital – Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Floriana Mascilini
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rita Trozzi
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Jessica Mauro
- Clinic of Obstetrics and Gynecology, “Santa Maria della Misericordia” University Hospital – Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
- University of Udine – Department of Medical Area (DAME), Udine, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, “Santa Maria della Misericordia” University Hospital – Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
- University of Udine – Department of Medical Area (DAME), Udine, Italy
| | - Paolo Casadio
- Division of Gynaecology and Human Reproduction Physiopathology, Istituto di ricovero e cura a carattere scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Anna Fagotti
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Vizzielli
- Clinic of Obstetrics and Gynecology, “Santa Maria della Misericordia” University Hospital – Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
- University of Udine – Department of Medical Area (DAME), Udine, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, Istituto di ricovero e cura a carattere scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
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Abdallah R, Chamsy D, Dagher C, Hajjar R, El Housheimi A, Seoud M, Khalil A. Borderline ovarian tumors: a retrospective cohort study on single institution experience, practice patterns and outcomes. J OBSTET GYNAECOL 2022; 42:3600-3604. [PMID: 36250321 DOI: 10.1080/01443615.2022.2130204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Borderline ovarian tumours (BOTs) commonly affect young nulliparous women, thus making fertility-preserving approaches more desirable. Women who opt for conservative management should be counselled about disease recurrence. In this retrospective study, the medical records of 57 women with BOT treated at the American University of Beirut Medical Centre between January 1986 and May 2018 were reviewed. Clinical, pathologic, and demographic data were collected and analysed to identify variables associated with poor clinical outcomes including advanced disease and risk of recurrence. Younger and nulliparous women were more likely to undergo fertility-sparing surgery. The open approach was adopted for women with larger adnexal masses and was associated with more blood loss with a mean difference of 172 mL (95% CI [110-235], p-value < .001) but no significant difference in operative time and length of hospital stay compared to the laparoscopic approach. CA-125 correlated with an advanced International Federation of Gynaecology and Obstetrics (FIGO) stage (p = .004). The recurrence rate was found to be 7% with a median recurrence time of 41.5 months.IMPACT STATEMENTWhat is already known on this subject? BOTs are common in young nulliparous women who often desire fertility-sparing procedures. Prognostic factors associated with disease severity and recurrence remain controversial.What do the results of this study add? This study presents an opportunity to understand the disease behaviour and compare local practices and outcomes to what was reported in the literature. CA-125 appears to be a useful marker in predicting the stage of BOT.What are the implications of these findings for clinical practice and/or further research? Future research should focus on exploring whether BOTs with micropapillary features represent an aggressive histologic subtype more prone to recurrence.
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Affiliation(s)
- Reem Abdallah
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Dina Chamsy
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christian Dagher
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rima Hajjar
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alaa El Housheimi
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Muhieddine Seoud
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Khalil
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
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Sharami SRY, Farhadifar F, Tabatabaei R. Recurrence and 5-year survival rate in patients with borderline ovarian tumors and related factors in Kurdistan. Eur J Transl Myol 2022; 33:10779. [PMID: 36173319 PMCID: PMC10141740 DOI: 10.4081/ejtm.2022.10779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/29/2022] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to investigate the recurrence rate and five-year survival in patients with borderline ovarian tumors and related factors. This retrospective cohort study was performed on 20 women diagnosed with a borderline ovarian tumor in Kurdistan province, Iran, between 2007 and 2019. Patients' records were reviewed and a researcher-made questionnaire was completed for each patient, which included demographic and clinical variables related to patient survival. The most common type of ovarian borderline tumor was the serous borderline ovarian tumor (75%). In fifty percent of the cases, cystectomy was used as th treatment. Recurrence was observed in three patients (15%), two of which were treated with cystectomy, and the other case was treated by TAH + BSO method (p = 0.64). There was no significant difference in terms of the type of surgery, history of infertility, history of taking contraceptive pills, age, age at diagnosis, and BMI between the two groups with and without recurrence (p > 0.05). The overall survival rate was 100% and none of the patients died at the end of follow-up. There was no relationship between any of the clinical and demographic variables with disease recurrence, and since all patients were alive after the end of the follow-up period. In summary, it was not possible to assess the relationship between patients' survival rate and studied variables.
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Affiliation(s)
| | - Fariba Farhadifar
- Social Determinants of Health Research Center, Department of Gynecology, Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj.
| | - Roya Tabatabaei
- Department of Obstetrics and Gynecology, Kurdistan University of Medical Sciences, Sanandaj.
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Dedushi K, Shatri J, Hyseni F, Musa J, Boshnjaku I, Meza-Contreras A, Saliaj K, Vokshi V, Kotorri B, Decka A, Capi L, Nasir F, Jahanian S, Amin AA, Ataullah A. Borderline ovarian tumor and MRI evaluation of a case report. Radiol Case Rep 2022; 17:3360-3366. [PMID: 35874872 PMCID: PMC9304877 DOI: 10.1016/j.radcr.2022.05.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 11/26/2022] Open
Abstract
Borderline ovarian tumors or atypical proliferative tumors are abnormal cells that arise from ovarian epithelium in contrast to ovarian cancers which form from stroma, the supportive tissue of ovaries. They are not invasive and tend to grow slowly. Many patients with BOTs are asymptomatic, while others have nonspecific symptoms like abdominal pain or abdominal distension. The absence of symptoms makes Borderline Ovarian Tumor hard to diagnose until it is in an advanced size or stage. Very rarely, the borderline tumor cells change into cancer cells. It usually affects patients at the reproductive age, for whom preserving the childbearing potential plays a very important role. In this report, we present the case of 58-year-old female patient who is presented to the neurosurgeon's office with complaints of lower abdominal pain. Incidentally while investigating the intervertebral discs through a lumbar MRI, an abnormal finding was present in the coronal view, where a mass was noted on the lower right adnexal region of the abdomen. The patient was referred to a gynecologist for further investigations, This case report emphasizes the high sensitivity and specificity of contrast MRI in the diagnosis of various pelvic pathologies in female patients.
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40
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Della Corte L, Mercorio A, Serafino P, Viciglione F, Palumbo M, De Angelis MC, Borgo M, Buonfantino C, Tesorone M, Bifulco G, Giampaolino P. The challenging management of borderline ovarian tumors (BOTs) in women of childbearing age. Front Surg 2022; 9:973034. [PMID: 36081590 PMCID: PMC9445208 DOI: 10.3389/fsurg.2022.973034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/09/2022] [Indexed: 11/14/2022] Open
Abstract
Borderline ovarian tumors (BOTs) account for approximately 15% of all epithelial ovarian cancers. In 80% of cases the diagnosis of BOTs is done at stage I and more than a third of BOTs occurs in women younger than 40 years of age wishing to preserve their childbearing potential; the issue of conservative surgical management (fertility-sparing treatment) is thus becoming of paramount importance. At early stages, the modalities of conservative treatment could range from mono-lateral cystectomy to bilateral salpingo-oophorectomy. Although cystectomy is the preferred method to promote fertility it can lead to an elevated risk of recurrence; therefore, an appropriate counseling about the risk of relapse is mandatory before opting for this treatment. Nevertheless, relapses are often benign and can be treated by repeated conservative surgery. Besides the stage of the disease, histological subtype is another essential factor when considering the proper procedure: as most mucinous BOTs (mBOTs) are more commonly unilateral, the risk of an invasive recurrence seems to be higher, compared to serous histotype, therefore unilateral salpingo-oophorectomy is recommended. In the appraisal of current literature, this review aims to gain better insight on the current recommendations to identify the right balance between an accurate staging and an optimal fertility outcome.
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Affiliation(s)
- Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mercorio
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
- Correspondence: Antonio Mercorio
| | - Paolo Serafino
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Viciglione
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Mario Palumbo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | | | - Maria Borgo
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Cira Buonfantino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Marina Tesorone
- Department of Child and Adolescent Health, U.O.C Protection of Women's- ASL Napoli 1, Naples, Italy
| | - Giuseppe Bifulco
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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41
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Gaughran J, Rosen O'Sullivan H, Lyne T, Abdelbar A, Abdalla M, Sayasneh A. Fertility Preserving Surgery Outcomes for Ovarian Malignancy: Data from a Tertiary Cancer Centre in Central London. J Clin Med 2022; 11:jcm11113195. [PMID: 35683582 PMCID: PMC9181136 DOI: 10.3390/jcm11113195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/30/2022] [Accepted: 05/16/2022] [Indexed: 01/27/2023] Open
Abstract
Fertility Sparing Surgery (FSS) appears to be a safe means of treating early-stage ovarian cancer based on relatively limited evidence. However, there is currently insufficient evidence to aid women in counselling about their potential fertility outcomes. The aim of this study was to assess the reproductive outcomes and prognosis of women who have undergone FSS for ovarian malignancy. Between 1 June 2008 and 1 June 2018, a retrospective review of a clinical database was conducted to identify all consecutive patients who underwent FSS in a central London gynaecological oncology centre. All patients with a histological diagnosis of ovarian malignancy (excluding borderline ovarian tumours) were eligible. All identified patients were then prospectively called into a follow up and asked to complete a questionnaire about their fertility outcomes. A total of 47 women underwent FSS; 36 were included in this study. The mean age was 30.3 years (95% Confidence Interval [CI]: 27.6 to 33.0 years). During the study period, 17/36 (47.2%) of the women had attempted to conceive following surgery, with a successful live birth rate of 52.9% (9/17). The mean time of recurrence was 125.3 months (95% CI: 106.5−144.1 months). The mean time to death was 139.5 months (95% CI: 124.3−154.8). The cancer grade, tumour stage and use of Assisted Reproductive Technology (ART) were the main factors significantly associated with the risk of recurrence and death. In conclusion, this study suggests that a large proportion of women will not attempt to conceive following FSS. For those who do attempt to conceive, the likelihood of achieving a live birth is high. However, careful counselling about the higher risk of recurrence and worse survival for women with high grade cancer, disease Stage > IA and potentially those who undergo ART is essential before contemplating FFS.
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Affiliation(s)
- Jonathan Gaughran
- Women's Health, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Hannah Rosen O'Sullivan
- Women's Health, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Tom Lyne
- Faculty of Life Sciences & Medicine at Guy's, The School of Life Course Sciences, King's College London, London WC2R 2LS, UK
| | - Ahmed Abdelbar
- Department of Gynaecological Oncology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Mostafa Abdalla
- Department of Gynaecological Oncology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Ahmad Sayasneh
- Faculty of Life Sciences & Medicine at Guy's, The School of Life Course Sciences, King's College London, London WC2R 2LS, UK
- Department of Gynaecological Oncology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
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42
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Haddad L, Kugelman N, Shapiro I, Bakry H, Weizman B, Korobochka R, Sagie S, Said-Idris S, Bejar J, Leibovitz Z. A New Insight on Exophytic Serous Borderline Adnexal Tumors: Specific Sonographic Features. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1549-1557. [PMID: 34562042 DOI: 10.1002/jum.15838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To characterize and compare the sonographic features of exophytic serous borderline ovarian tumors (ESBOT) with those of high-grade serous carcinoma of the ovary (HGSC). METHODS Seven patients with histological diagnosis of ESBOT diagnosed between 2011 and 2019 and 10 consecutive cases of HGSC detected during 2019, both depicting an exophytic growth pattern, were identified retrospectively. The sonographic imaging of the masses was reassessed and characterized according to the International Ovarian Tumor Analysis terms. RESULTS A unilateral irregular solid adnexal mass was demonstrated in all patients with ESBOT. The mass typically wrapped an apparently normal ovary, with a clear demarcation line depicted between them and it contained tiny cystic inclusions and calcifications. On color Doppler study of all the ESBOT cases, a unique vascular pattern could be demonstrated: an intratumoral vascular bundle originating from the ovarian vessels and supplying a rich radial blood flow to the tumor periphery. These characteristic morphological and color Doppler features could not be observed in any of the HGSC cases (P < .001). In 42.8% of the patients with ESBOT, additional unilocular-solid components (ipsilateral or contralateral) could be detected, whereas all the HGSC patients presented with a multilocular-solid tumor morphology (P < .001). The interface of the external mass border with the adjacent pelvic walls was regular in all the cases with ESBOT, whereas in 80% of HGSC patients, it was irregular, suggesting invasiveness (P = .002). CONCLUSIONS ESBOT can mimic HGSC. Our results suggest that ESBOT has specific B-mode and color Doppler features, enabling differentiation from HGSC and planning appropriate intervention.
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Affiliation(s)
- Leila Haddad
- Obstetrics and Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Nir Kugelman
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel
| | - Israel Shapiro
- Obstetrics and Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Haifa, Israel
| | - Hasan Bakry
- Obstetrics and Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Boris Weizman
- Obstetrics and Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Haifa, Israel
| | - Roman Korobochka
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Obstetrics and Gynecology, Bnai-Zion Medical Center, Haifa, Israel
| | - Shlomi Sagie
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Obstetrics and Gynecology, Bnai-Zion Medical Center, Haifa, Israel
| | - Suraya Said-Idris
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Obstetrics and Gynecology, Bnai-Zion Medical Center, Haifa, Israel
| | - Jacob Bejar
- Department of Pathology, Bnai-Zion Medical Center, Haifa, Israel
| | - Zvi Leibovitz
- Obstetrics and Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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43
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Beroukhim G, Ozgediz D, Cohen PJ, Hui P, Morotti R, Schwartz PE, Yang-Hartwich, Vash-Margita A. Progression of Cystadenoma to Mucinous Borderline Ovarian Tumor in Young Females: Case Series and Literature Review. J Pediatr Adolesc Gynecol 2022; 35:359-367. [PMID: 34843973 DOI: 10.1016/j.jpag.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/23/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE To study the progression of benign ovarian lesions to mucinous borderline ovarian tumors (mBOTs); analyze the clinicopathologic features, diagnosis, and management of mBOTs in pediatric and adolescent girls; and provide a review of the literature on mBOTs in this population. DESIGN Retrospective chart review of female adolescents younger than 18 years diagnosed with mBOTs between July 2017 and February 2021. SETTING Yale New Haven Hospital, New Haven, Connecticut; and Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut. PARTICIPANTS Three female patients diagnosed with mBOTs between ages 12 and 17 years. INTERVENTIONS None. MAIN OUTCOME MEASURES Clinical presentation, preoperative characteristics, surgical technique, histology, tumor stage, treatment, progression, outcome, and rate of recurrence. RESULTS Three adolescent patients were identified to have mBOTs. All three patients presented with a chief complaint of abdominal pain. One of the 3 patients was premenarchal at presentation. Two of the 3 patients were initially diagnosed with a mucinous cystadenoma and had recurrences of an ovarian cyst in the same ovary within 5 and 17 months, respectively. Pathology of the recurrent cyst was consistent with mBOT. Two of the 3 patients initially underwent cystectomy, and all ultimately had a unilateral salpingo-oophorectomy. Subsequent surveillance over 2 to 4 years found no evidence of disease recurrence. CONCLUSION mBOTs are rare in the pediatric and adolescent population and could arise from benign ovarian tumors.
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Affiliation(s)
- Gabriela Beroukhim
- Department of Obstetrics, Gynecology and Reproductive Sciences at Yale New Haven Hospital and Yale University School of Medicine, New Haven, Connecticut
| | - Doruk Ozgediz
- Department of Pediatric Surgery at University of California, San Francisco (UCSF), San Francisco, California
| | - Paul J Cohen
- Department of Pathology at Bridgeport Hospital and Yale University, New Haven, Connecticut
| | - Pei Hui
- Department of Pathology at Yale New Haven Hospital and Yale University, New Haven, Connecticut
| | - Raffaella Morotti
- Department of Pathology at Yale New Haven Hospital and Yale University, New Haven, Connecticut
| | - Peter E Schwartz
- Department of Obstetrics, Gynecology and Reproductive Sciences at Yale New Haven Hospital and Yale University School of Medicine, New Haven, Connecticut
| | - Yang-Hartwich
- Department of Obstetrics, Gynecology and Reproductive Sciences at Yale New Haven Hospital and Yale University School of Medicine, New Haven, Connecticut; Yale Cancer Center, New Haven, Connecticut
| | - Alla Vash-Margita
- Department of Obstetrics, Gynecology and Reproductive Sciences at Yale New Haven Hospital and Yale University School of Medicine, New Haven, Connecticut.
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44
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Ricotta G, Maulard A, Candiani M, Scherrier S, Genestie C, Pautier P, Leary A, Chargari C, Mangili G, Morice P, Gouy S. Endometrioid Borderline Ovarian Tumor: Clinical Characteristics, Prognosis, and Managements. Ann Surg Oncol 2022; 29:5894-5903. [PMID: 35590116 DOI: 10.1245/s10434-022-11893-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/27/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Endometrioid borderline ovarian tumor (EBOT) is a rare subtype of borderline ovarian malignancies. This study was designed to determine the prognosis of a series of EBOT. METHODS This is a retrospective review of patients with EBOT treated in or referred to our institutions and a centralized, histological review by a reference pathologist. Data on the clinical characteristics, management (surgical and medical), and oncologic outcomes of patients were required for inclusion. RESULTS Forty-eight patients were identified. Median age was 52 years (range 14-89). Fourteen patients underwent a conservative surgery and 32 a bilateral salpingo-oophorectomy (unknown in 2 cases). Two patients had bilateral tumors. Forty-three patients had stage I disease, and five patients had stage II disease (10%). Stromal microinvasion and intraepithelial carcinoma was observed in 6 (12%) and 13 (27%) patients respectively. Endometriosis was histologically associated in 12 patients (25%). Synchronous endometrial disease was found in 7 (24%) of 29 patients with endometrial histological evaluation. The median follow-up was 72 months (range 6-146). Two patients developed a recurrence after cystectomy in form of borderline disease (5%). No death related to EBOT occurred. CONCLUSIONS Peritoneal restaging surgery should be performed if not realized initially, because 5% of EBOTS are diagnosed at stage II-III. Fertility-sparing surgery seems a safe option in selected patients. Because synchronous endometrial diseases, including endometrial carcinoma are frequent, systematic hysterectomy (or endometrial sampling in case of fertility-sparing surgery) is mandatory. Prognosis is generally excellent. Recurrence is a rare event (6%), but it can occur in the form of invasive disease.
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Affiliation(s)
- Giulio Ricotta
- Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France
| | - Amandine Maulard
- Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France
| | - Massimo Candiani
- IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | | | | | - Patricia Pautier
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Alexandra Leary
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Cyrus Chargari
- Department of Radiation Oncology, Gustave-Roussy, Villejuif, France
| | - Giorgia Mangili
- IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Philippe Morice
- Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France. .,Paris Sud University Kremlin-Bicêtre, Le Kremlin-Bicêtre, France.
| | - Sébastien Gouy
- Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France
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45
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Timor-Tritsch IE, Monteagudo A, Popiolek DA, Duncan KM, Goldstein SR. Reaffirming microcystic ultrasound appearance of borderline ovarian tumors using three-dimensional 'silhouette' rendering. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 59:700-704. [PMID: 35195307 DOI: 10.1002/uog.24883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/04/2022] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Affiliation(s)
- I E Timor-Tritsch
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - A Monteagudo
- Icahn School of Medicine, Carnegie Imaging for Women, New York, NY, USA
| | - D A Popiolek
- Department of Pathology, New York University School of Medicine, New York, NY, USA
| | - K M Duncan
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - S R Goldstein
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
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46
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Sahraoui G, Fitouri A, Charfi L, Driss M, Slimane M, Hechiche M, Mrad K, Doghri R. Mucinous borderline ovarian tumors: pathological and prognostic study at Salah Azaiez Institute. Pan Afr Med J 2022; 41:349. [PMID: 35909430 PMCID: PMC9279460 DOI: 10.11604/pamj.2022.41.349.32332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 04/10/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction ovarian Mucinous Borderline Tumors (MBT) are characterized by an epithelial proliferation similar to those of well differentiated adenocarcinomas but are distinguished by the absence of stromal invasion. They are often difficult to diagnose histologically. The aim of the work was to specify the pathological and clinical features and to highlight the prognostic of these tumors. Methods study was retrospective including 49 cases of primary ovarian MBT, diagnosed at the Patholgy Department of Salah Azaiez Institute from 1992 to 2019. Results median age was 48 years old. Histologically, the cases were divided into 34 cases of pure MBT, 13 cases with intraepithelial carcinoma and 2 cases associating an intraepithelial carcinoma with microinvasion. The majority of our cases were classified FIGO I and only one case FIGO III. Sixteen patients received conservative treatment and 30 received radical treatment. The treatment wasn't specified in three patients. The prognosis was good in the majority of cases. Only one patient had a contralateral recurrence after a follow-up period of three years. There were no significant differences regarding the risk of recurrence and risk factors such as age, gestation, hormonal status, FIGO stage and conservative treatment. We raised this part. Conclusion the prognosis of the ovarian MBT is good. However, it is necessary to multiply the samples to avoid missing a carcinomatous focus with an anarchic invasion of the stroma which constitutes a poor prognosis factor. It was changed by these sentences below: the diagnosis of MBT is not easy. Indeed, the distinction of MBT from carcinomas remains the greatest challenge for pathologists. Once this diagnosis is made with certainty, the tumor can be considered to have a good prognosis, especially stage I tumors which are the most common.
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Affiliation(s)
- Ghada Sahraoui
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia,,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Asma Fitouri
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia,,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,,Precision Medicine, Personalized Medicine and Oncology Investigation laboratory, LR21SP01, Tunis, Tunisia,Corresponding author: Asma Fitouri, Pathology Department, Salah Azaiez Institute, Tunis, Tunisia.
| | - Lamia Charfi
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia,,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,,Precision Medicine, Personalized Medicine and Oncology Investigation laboratory, LR21SP01, Tunis, Tunisia
| | - Maha Driss
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia,,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,,Precision Medicine, Personalized Medicine and Oncology Investigation laboratory, LR21SP01, Tunis, Tunisia
| | - Maher Slimane
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia,,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Monia Hechiche
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia,,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,,Precision Medicine, Personalized Medicine and Oncology Investigation laboratory, LR21SP01, Tunis, Tunisia
| | - Karima Mrad
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia,,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,,Precision Medicine, Personalized Medicine and Oncology Investigation laboratory, LR21SP01, Tunis, Tunisia
| | - Raoudha Doghri
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia,,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,,Precision Medicine, Personalized Medicine and Oncology Investigation laboratory, LR21SP01, Tunis, Tunisia
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47
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Mohapatra I, Samantaray SR, Harshini N. Fertility-Preserving Surgery of Borderline Serous Ovarian Tumors: A Case Report. Cureus 2022; 14:e24128. [PMID: 35573497 PMCID: PMC9106565 DOI: 10.7759/cureus.24128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/17/2022] Open
Abstract
Borderline ovarian tumors (BOTs) are tumors with low malignant potential and have an excellent prognosis. They are distinct by an epidemiological shift toward younger women. Fertility-sparing surgery is considered the gold standard in young patients presenting with BOTs. Spontaneous conception has been reported after conservative surgery with no enhanced risk of mortality or morbidity from disease progression during pregnancy. The prognosis of BOTs is very good; however, a small proportion of these tumors may recur and show malignant transformation. Timely follow-up of the patients is required for timely detection of any recurrence. We are presenting here a case of a 23-year-old woman diagnosed with BOT. The patient was nulliparous and hence was the appropriate candidate for fertility-sparing surgery. She underwent unilateral salpingo-oophorectomy and is now on regular follow-up.
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48
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Lu Z, Lin F, Li T, Wang J, Liu C, Lu G, Li B, Pan M, Fan S, Yue J, Huang H, Song J, Gu C, Li J. Identification of clinical and molecular features of recurrent serous borderline ovarian tumour. EClinicalMedicine 2022; 46:101377. [PMID: 35434581 PMCID: PMC9011028 DOI: 10.1016/j.eclinm.2022.101377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Serous borderline ovarian tumour (SBOT) is the most common type of BOT. Fertility sparing surgery (FSS) is an option for patients with SBOT, though it may increase the risk of recurrence. The clinical and molecular features of its recurrence are important and need to be investigated in detail. METHODS An internal cohort of 319 patients with SBOT was collected from Aug 1, 2009 to July 31, 2019 from the Obstetrics and Gynecology Hospital of Fudan University in China. An external cohort of 100 patients with SBOT was collected from Aug 1, 2009 to Nov 30, 2019 from the Shandong Provincial Hospital in China. The risk factors for the recurrence were identified by multivariate cox analysis. Several computational methods were tested to establish a prediction tool for recurrence. Whole genome sequencing, RNA-seq, metabolomics and lipidomics were used to understand the molecular characteristics of the recurrence of SBOT. FINDINGS Five factors were significantly correlated with SBOT recurrence in a Han population: micropapillary pattern, advanced stage, FSS, microinvasion, and lymph node invasion. A random forest-based online recurrence prediction tool was established and validated using an internal cohort and an independent external cohort for patients with SBOT. The multi-omics analysis on the original SBOT samples revealed that recurrence is related to metabolic regulation of immunological suppression. INTERPRETATION Our study identified several important clinical and molecular features of recurrent SBOT. The prediction tool we established could help physicians to estimate the prognosis of patients with SBOT. These findings will contribute to the development of personalised and targeted therapies to improve prognosis. FUNDING JL was funded by MOST 2020YFA0803600, 2018YFA0801300, NSFC 32071138, and SKLGE-2118 to Jin Li; JY was funded by the Initial Project for Young and Middle-aged Medical Talents of Wuhan City, Hubei Province ([2014] 41); HH was funded by MOST 2019YFA0801900 and 2020YF1402600 to He Huang; JS was funded by NSFC 22,104,080; CG was funded by Natural Science Foundation of Shanghai 20ZR1408800 and NSFC82171633; BL was funded by Natural Science Foundation of Shanghai 19ZR1406800.
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Affiliation(s)
- Ziyang Lu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
| | - Fanghe Lin
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Key Laboratory for Chemical Biology of Fujian Province, Key Laboratory of Analytical Chemistry, Department of Chemical Biology, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
| | - Tao Li
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Jinhui Wang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
| | - Cenxi Liu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
| | - Guangxing Lu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
| | - Bin Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
| | - MingPei Pan
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
| | - Shaohua Fan
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
| | - Junqiu Yue
- Department of Pathology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
| | - He Huang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
| | - Jia Song
- Institute of Molecular Medicine, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai 200127, China
- Corresponding authors.
| | - Chao Gu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
- Corresponding authors.
| | - Jin Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China
- Institute of Cell Biology and Biophysics, Leibniz University Hannover, Hanover, Germany
- Corresponding author at: State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Institute of Metabolism and Integrative Biology, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai 200438, China.
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Ataikiru UO, Iacob ER, Miron I, Popoiu CM, Boia ES. A 10-year retrospective single-center study of alpha-fetoprotein and beta-human chorionic gonadotropin in Romanian children with (para)gonadal tumors and cysts. J Pediatr Endocrinol Metab 2022; 35:363-371. [PMID: 34968016 DOI: 10.1515/jpem-2021-0382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 12/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Malignant tumor is a top-ranking cause of pediatric (>1-year) mortality in America and Europe. Among pediatric tumors, germ cell tumors (GCT) and gonadal tumors rank fourth (6%) by the Surveillance, Epidemiology, and End Results (SEER) program (seer.cancer.gov). Continuous research on tumor markers harnesses their full potential in tumor detection and management. We evaluated the effectiveness of beta-human chorionic gonadotropin (β-hCG) and Alpha-fetoprotein (AFP) in Romanian children with (para)gonadal tumors and cysts, determining their accuracy in detecting malignancy, tumor-type, stage, complications, prognosis, and treatment response. METHODS A 10-year retrospective study of AFP and β-hCG in 134 children with cysts and (para)gonadal tumors aged one month to 17 years was performed. RESULTS AFP/β-hCG was unelevated in patients with cysts and nonmalignant tumors. Forty-eight/86 patients (43 GCT and 5 non-GCT) with malignant tumors had elevated AFP/β-hCG, 3/48 patients had recurrences, and 25/48 had mixed-GCT (68% had elevated AFP + β-hCG). All 30 patients with Yolk sac tumors (YST) or their components had elevated AFP. Area under the curve, sensitivity and specificity for GCT were: AFP + β-hCG- 0.828, 67.2%, 100%; AFP- 0.813, 64.1%, 100%; and β-hCG- 0.664, 32.8%, 100%. Two patients whose AFP/β-hCG levels remained elevated died. Common mixed-GCT components were YST-80% and embryonal carcinoma-72%. Thirty of 34 metastasis cases were GCT, with 26/34 patients having elevated AFP/β-hCG. CONCLUSIONS AFP/β-hCG detects malignant GCT and can determine tumor-type. GCT patients with markedly elevated AFP + β-hCG had poor prognosis, especially if recurrence or metastasis was present. Recurrence is unrelated to elevated AFP/β-hCG. The tumor components and quantity present determine AFP/β-hCG values in mixed-GCT.
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Affiliation(s)
- Usiwoma O Ataikiru
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Childrens Hospital, Timisoara, Romania
| | - Emil R Iacob
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Childrens Hospital, Timisoara, Romania
| | - Ingrith Miron
- Department of Pediatric Hematology and Oncology, Saint Mary Clinical Emergency Hospital for Children, Iasi, Romania
| | - Calin M Popoiu
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Childrens Hospital, Timisoara, Romania
| | - Eugen S Boia
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Childrens Hospital, Timisoara, Romania
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Association of recurrent mutations in BRCA1, BRCA2, RAD51C, PALB2, and CHEK2 with the risk of borderline ovarian tumor. Hered Cancer Clin Pract 2022; 20:11. [PMID: 35313928 PMCID: PMC8935754 DOI: 10.1186/s13053-022-00218-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background There are several genes associated with ovarian cancer risk. Molecular changes in borderline ovarian tumor (BOT) indicate linkage of this disease to type I ovarian tumors (low-grade ovarian carcinomas). This study determined the prevalence and association of mutations in BRCA1, BRCA2, PALB2, RAD51C, and CHEK2 with the risk of BOTs. Methods The study group consisted of 102 patients with histologically confirmed BOT and 1743 healthy controls. In addition, 167 cases with ovarian cancer G1 were analyzed. The analyses included genotyping of 21 founder and recurrent mutations localized in 5 genes (BRCA1, BRCA2, PALB2, RAD51C, and CHEK2). The risk for developing BOT and low-grade ovarian cancer, as well as the association of tested mutations with survival, was estimated. Results The CHEK2 missense mutation (c.470T>C) was associated with 2-times increased risk of BOT (OR=2.05, p=0.03), at an earlier age at diagnosis and about 10% worse rate of a 10-year survival. Mutations in BRCA1 and PALB2 were associated with a high risk of ovarian cancer G1 (OR=8.53, p=0.005 and OR=7.03, p=0.03, respectively) and were related to worse all-cause survival for BRCA1 carriers (HR=4.73, 95%CI 1.45–15.43, p=0.01). Conclusions Results suggest that CHEK2 (c.470T>C) may possibly play a role in the pathogenesis of BOT, but due to the low number of BOT patients, obtained results should be considered as preliminary. Larger more in-depth studies are required.
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