Clinical And Pathological Characteristics Of Borderline Ovarian Tumors With Different Levels Of Invasion: An Analysis Of51Cases

Objectives：To study the clinical and pathological characteristics, treatment and prognoses ofborderline ovarian tumor(B0T), BOT with micro-invasion (BOT-MI)and BOT with foci oflow grade epithelial ovarian cancer (BOT-LGEOC).Methods：A retrospective analysis of women diagnosed with borderline ovarian tumor and treatedbetween January2007and January2012was conducted. Patients were divided into threegroups: BOT, BOT with MI and BOT-LGEOC based on their pathological diagnoses.Clinical data, ultrasound manifestations, pathologic characteristics, immunohistalchemicalexpression of VEGF, operation, chemotherapy and prognosis was compared between threegroups.Results：The medium ages of patients were29,26.5and28years. Patients of pre-menopausalstatus were93.1%，8/8and84.2%;50%，5/8and68.4%were nulliparous. The medium diameter of tumors were10.4cm，11.4cm and14.7cm，and the medium volumes were394.21ml，540.3ml and1084.3ml;25%，7/8and78.9%of tumors displayed rich bloodflow.54.2%，4/8and78.9%of patients had abnormal tumor markers. For serousborderline tumors and endometrial borderline tumors, the medium CA-125were44.2U/ml，33.1U/ml，189.6U/ml. All patients received operation; FIGO stage I were41.7%，6/8and57.9%;41.7%，5/8and36.8%received conservative operation;41.7%，1/8and26.3%had restaging procedures and5/10，0/1，2/5of them were upstaged.21,6,19patients had pelvic lymph node dissection with or without para-aortic lymph nodedissection,38.1%,1/6,5.2%were lymph node positive. The accuracy of frozen sectionwas54.3%, the sensitivity was90.4%and the positive predictive value was61.2%; noneof the BOT-LGEOC were diagnosed during operations. Positive rate of VEGF were42.8%,4/7and50%.45.8%,7/8and89.4%of patients had chemotherapy. For22cases whoreceived conservative operations,3cases had shorter menstrual cycles afterwards. For10patients who had family plans, three patients had five pregnancies and three full-termdeliveries. Two patients recurred.Conclusions：BOT is consisted of a continuum of diseases. Making accurate diagnosis ofBOT-LGEOC is difficult during operations. For patients who have abnormal tumormarkers and some typical ultrasound manifestations, a diagnosis of BOT-LGEOC cannotbe overlooked. There is no difference of expression of VEGF in BOT with different levelsof invasion. For patients with family plans, a conservative operation might be consideredregardless of their stages. Avoidance of performing cystectomy might lower recurrencerate.