TY - JOUR
T1 - Adjuvant platinum-based chemotherapy for borderline serous ovarian tumors with invasive implants
AU - Leary, Alexandra
AU - Petrella, Marie Christina
AU - Pautier, Patricia
AU - Duvillard, Pierre
AU - Uzan, Catherine
AU - Tazi, Youssef
AU - Ledoux, Florence
AU - Gouy, Sébastien
AU - Morice, Philippe
AU - Lhommé, Catherine
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Background Most borderline ovarian tumors (BOTs) are cured with surgery. However BOTs with invasive implants have a poor prognosis with a mortality of 20-40%. The benefit of adjuvant chemotherapy (CT) in this setting remains poorly defined. Methods Retrospective study of serous BOT + invasive implants treated with adjuvant CT. Results 36 patients were referred with serous BOTs + invasive implants and treated with surgery and platinum-based CT between 06/1982 and 02/2011. 83% were stage III/IV. Tumors demonstrated microinvasion, micropapillary pattern or desmoplastic implants in 53%, 47% and 67% of cases, respectively. 8% had fertility-sparing surgery. Taking into account initial and completion surgeries, R0 was achieved in 84% (27/32) (NA, N = 4). The majority (72%) received a combination of platinum + taxane. 11% of patients experienced a G3/G4 toxicity. 13 of 36 (36%) patients relapsed at a median of 27.3 months after diagnosis of invasive implants. Among 12 patients with histologically confirmed relapse, 8 patients progressed with invasive disease in the form of carcinoma or invasive implants. 5 year PFS/OS were 67%/96%. Neither microinvasion, micropapillary pattern, nor desmoplastic implants predicted relapse. In cases with evaluable disease, an objective response to chemotherapy was observed in 4 of 6 patients. Conclusion This is the largest study of BOT with invasive implants treated with surgery and adjuvant platinum-based CT. Treatment was well tolerated and the invasive relapse rate was 22% (8/36). Although numbers are small, the objective responses suggest a possible role for adjuvant CT in BOTs with invasive implants.
AB - Background Most borderline ovarian tumors (BOTs) are cured with surgery. However BOTs with invasive implants have a poor prognosis with a mortality of 20-40%. The benefit of adjuvant chemotherapy (CT) in this setting remains poorly defined. Methods Retrospective study of serous BOT + invasive implants treated with adjuvant CT. Results 36 patients were referred with serous BOTs + invasive implants and treated with surgery and platinum-based CT between 06/1982 and 02/2011. 83% were stage III/IV. Tumors demonstrated microinvasion, micropapillary pattern or desmoplastic implants in 53%, 47% and 67% of cases, respectively. 8% had fertility-sparing surgery. Taking into account initial and completion surgeries, R0 was achieved in 84% (27/32) (NA, N = 4). The majority (72%) received a combination of platinum + taxane. 11% of patients experienced a G3/G4 toxicity. 13 of 36 (36%) patients relapsed at a median of 27.3 months after diagnosis of invasive implants. Among 12 patients with histologically confirmed relapse, 8 patients progressed with invasive disease in the form of carcinoma or invasive implants. 5 year PFS/OS were 67%/96%. Neither microinvasion, micropapillary pattern, nor desmoplastic implants predicted relapse. In cases with evaluable disease, an objective response to chemotherapy was observed in 4 of 6 patients. Conclusion This is the largest study of BOT with invasive implants treated with surgery and adjuvant platinum-based CT. Treatment was well tolerated and the invasive relapse rate was 22% (8/36). Although numbers are small, the objective responses suggest a possible role for adjuvant CT in BOTs with invasive implants.
KW - Adjuvant chemotherapy
KW - Invasive implants
KW - Serous borderline ovarian tumor
UR - http://www.scopus.com/inward/record.url?scp=84892808121&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2013.11.006
DO - 10.1016/j.ygyno.2013.11.006
M3 - Article
C2 - 24219980
AN - SCOPUS:84892808121
SN - 0090-8258
VL - 132
SP - 23
EP - 27
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -