Behavior of serous borderline ovarian tumors with and without micropapillary patterns: Results of a French multicenter study

Background. Behavior of serous borderline ovarian tumors with micropapillary patterns (MP-SBOT) is thought to be worse than those without micropapillary patterns, but few cohort studies have compared epidemiological characteristics, surgical management, and recurrence rates between these two groups. Methods. In a French retrospective multicenter study of 475 borderline ovarian tumors (BOT) treated from 1990 to 2009, we studied patients with a serous BOT and treated after 2000 including 20 patients with and 77 patients without micropapillary patterns. Results. Patients with MP-SBOT were younger (P = 0.01), often asymptomatic (P = 0.04), and with abnormal CA 125 serum levels (P = 0.04). Peritoneal implants were more frequently observed in these patients (P = 0.01); also, they underwent conservative treatment more frequently (P = 0.002), had a higher risk of misdiagnosis with invasive carcinoma by intraoperative histology (P < 0.05), and had more frequent restaging surgery (P = 0.001). No difference in recurrence was noted between the groups. No disease-related mortality was observed. Conclusions. Patients with MP-SBOT represent a heterogeneous population in terms of presence of invasive peritoneal implants. Conservative surgery could be a suitable option for MP-SBOT patients without implants and who wish to conserve childbearing potential, without increasing the risk of recurrence.