Fatih SAHİN, Erhan AKTÜRK, Osman Samet GÜNKAYA, Savaş ÖZDEMİR, Merve KONAL, Simten GENÇ, Arzu YURCİ, Ozgur AKBAYİR

Borderline ovarian tumors: twenty years of experience at a tertiary center

Anahtar Kelimeler:

Borderline epithelial ovarian tumors, tumor markers, CA 125

Borderline ovarian tumors: twenty years of experience at a tertiary center

Aims: To investigate whether there is a difference between serum tumor markers panel (CA 125, CA 19-9, CA 15-3, and carcinoembryonic antigen (CEA)) and tumor size and histopathology in well-staged patients with borderline ovarian tumors (BOTs). Methods: Over the past 20 years (January 2001 to January 2021), the results of four tumor markers (CA 125, CA 19-9, CA 15-3, and carcinoembryonic antigen (CEA)) have been clinically analyzed for for this retrospective cohort study of 156 patients who underwent surgery and were diagnosed with histopathology consistent with a borderline ovarian tumor. Results: The average age of patients with borderline ovarian tumors was determined to be 51.67 (4.726) years. Before the first surgery, high CA 125 levels (>35 U/l) were found in 53 patients (34%), high CEA levels (>4 ng/ml) were found in 24 patients (15.4%), high CA 19-9 levels (>37 U/ml) were found in 29 patients (18.6%), and high CA 15-3 (>30 ng/ml) levels were found in 12 patients (7.7%). The average CA 125 levels in tumors with serous histopathology [372.8 (1805.2)] were higher than those in tumors with mucinous histopathology (p=0.006). There was no statistically significant difference in tumor markers between tumors smaller than 8 cm and larger than 8 cm [(CA 125 p=0,257), (CEA p=0.9), (CA 19-9 p=0.295), (CA 15-3 p=0.404)]. Conclusion: Our primary outcome of the study is an increase in CA 125 levels, which indicates serous histopathology. Our secondary outcome is the higher levels of tumor markers, but it does not suggest larger tumors.

Keywords:

Borderline epithelial ovarian tumors, tumor markers, CA 125,

PDF

___

Yilmaz E, Sahin N, Koleli I, et al. Retrospective analysis of borderline ovarian tumors: outcomes at a single center. Acta Clin Croat 2019; 58: 29–36.
Morris CR, Liu L, Rodriguez AO, Cress DR, Snipes K. Epidemiologic features of borderline ovarian tumors in California: a population-based study. Cancer Causes Control 2013; 24: 665–74.
Rasmussen CB, Jensen A, Albieri V, Andersen KK, Kjaer SK. Increased risk of borderline ovarian tumors in women with a history of pelvic inflammatory disease: A nationwide population-based cohort study. Gynecol Oncol 2016; 143: 346-51.
Matsuo K, Machida H, Mandelbaum RS, et al. Mucinous borderline ovarian tumor versus invasive well-differentiated mucinous ovarian cancer: Difference in characteristics and outcomes. Gynecol Oncol 2019; 153: 230-37.
Solmaz Hasdemir P, Guvenal T. Borderline ovarian tumors: a contemporary review of clinicopathological characteristics, diagnostic methods and therapeutic options. J BUON 2016; 21: 780–6.
Tropé C, Davidson B, Paulsen T, Abeler VM, Kaern J. Diagnosis and treatment of borderline ovarian neoplasms: the state of the art. Eur J Gynaecol Oncol 2009; 30: 471–82.
Bast RC Jr, Feeney M, Lazarus H, Nadler LM, Colvin RB, Knapp RC. Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest 1981; 68: 1331-7.
Van Haaften-Day C, Shen Y, Xu F, et al. OVX1, macrophage-colony stimulating factor, and CA-125-II as tumor markers for epithelial ovarian carcinoma: a critical appraisal. Cancer 2001; 92: 2837-44.
Gotlieb WH, Soriano D, Achiron R, et al. CA 125 measurement and ultrasonography in borderline tumors of the ovary. Am J Obstet Gynecol 2000; 183: 541-6.
Fotopoulou C, Sehouli J, Ewald-Riegler N, de Gregorio N, et al. The value of serum CA125 in the diagnosis of borderline tumors of the ovary: a subanalysis of the prospective multicenter ROBOT Study. Int J Gynecol Cancer 2015; 25: 1248-52.
Rice LW, Lage JM, Berkowitz RS, et al. Preoperative serum CA-125 levels in borderline tumors of the ovary. Gynecol Oncol 1992; 46: 226-9.
Tamakoshi K, Kikkawa F, Shibata K, et al. Clinical value of CA125, CA19-9, CEA, CA72-4, and TPA in borderline ovarian tumor. Gynecol Oncol 1996; 62: 67-72.
Ayhan A, Guven S, Guven ES, Kucukali T. Is there a correlation between tumor marker panel and tumor size and histopathology in well staged patients with borderline ovarian tumors? Acta Obstet Gynecol Scand 2007; 86: 484-90.
Dede M, Gungor S, Yenen MC, et al. CA19-9 may have clinical significance in mature cystic teratomas of the ovary. Int J Gynecol Cancer 2006; 16: 189–93.
Mirjam J.A. Engelen, Henk W.A. de Bruijn, Harrie Hollema, et al. Serum CA 125, Carcinoembryonic Antigen, and CA 19-9 as Tumor Markers in Borderline Ovarian Tumors, Gynecologic Oncology 2000; 78: 16-20.
Chen X, Fang C, Zhu T, Zhang P, Yu A, Wang S. Identification of factors that impact recurrence in patients with borderline ovarian tumors. J Ovarian Res 2017; 10: 23.
May J, Skorupskaite K, Congiu M, et al. Borderline Ovarian Tumors: Fifteen Years’ Experience at a Scottish Tertiary Cancer Center. Int J Gynecol Cancer 2018; 28: 1683-91.
Yedema KA, Kenemans P, Wobbes T, et al. Carcinoma-associated mucin serum markers CA M26 and CA M29: efficacy in detecting and monitoring patients with cancer of the breast, colon, ovary, endometrium and cervix. Int J Cancer 1991; 47: 170-9.
Schutter EM, Davelaar EM, Van Kamp GJ, Verstraeten RA, Kenemans P, Verheijen RH. The differential diagnostic potential of a panel of tumor markers (CA 125, CA 15-3, and CA 72-4 antigens) in patients with a pelvic mass. Am J Obstet Gynecol 2002; 187: 385-92.