BORDERLİNE OVER TÜMÖRLERİ: TANI,TEDAVİ, TAKİP
Düşük malignite potansiyelli over tümörü olarak bilinen, Borderline over tümörü (BOT), tüm over malignitelerinin %10 - 20’si kadardır. BOT’un en sık görülen histolojik tipleri sırasıyla seröz ve müsinöz tiplerdir, daha nadir olarak endometrioid, şeffaf hücreli, transisyonel ve miks tipler vardır. Hastalar sıklıkla daha genç yaşlarda tanı alırlar, bu yüzden hastalığın klinik yönetiminde, fertilite koruyucu ve postoperatif morbiditeyi azaltıcı yöntemler kullanılmalıdır. BOT’un ameliyat öncesi tanınması mümkün değildir, sıklıkla cerrahi esnasında frozen section veya operasyon sonrası over dokusunun histolojik incelenmesi ile tanı alır. Bu makale, okuyucuya BOT ile ilgili son yayımlanan bilgileri sunmayı hedeflemiştir.
BORDERLİNE OVARİAN TUMORS:DİAGNOSİS, TREATMENT & FOLLOW-UP
Borderline ovarian tumor (BOT), also known as tumors of low malignant potential, represent 10-20% of all ovarian malignancies. Histologically, the majority of BOTs are serous or mucinous; however, they may also have clear cell, endometrioid, Brenner (transitional cell) or mixed histology. As they frequently affect younger patients the clinical management is complicated by considerations such as preserving fertility and reducing postoperative morbidity. Due to the absence of specific preoperative criteria, diagnosis is often made during surgery or after the anatomopathologic examination. This review will attempt to inform readers about the recent data concerning these topics.
___
- 1. Taylor HC Jr. Malignant and semi-malignant tumors of
the ovary. Surg Gynecol Obstset. 1929;48:204-230.
- 2. Morice P, Uzan C, Fauvet R, Gouy S, Duvillard P, Darai E.
Borderline ovarian tumour: pathological diagnostic dilemma
and risk factors for invasive or lethal recurrence.
Lancet Oncol 2012; 13(3):e103–e115.
- 3. Sherman ME, Mink PJ, Curtis R et al. Survival among
women with borderline ovarian tumors and ovarian
carcinoma: A population-based analysis. Cancer
2004;100:1045–1052.
- 4. Mink P, Sherman ME, Devesa S. Incidence patterns of
invasive and borderline ovarian tumors among white
women and black women in the United States: results
from the SEER program, 1978–1997. Cancer 2002; 95:
2380–89.
- 5. Morice P. Borderline tumours of the ovary and fertility.
Eur J Cancer 2006;42:149 –158.
- 6. Guvenal T, Dursun P, Hasdemir P et al. Effect of surgical
staging on 539 patients with borderline ovarian tumors:
A Turkish Gynecologic Oncology Group study Gynecologic
Oncology 2013;131:546–550
- 7. Gungor T, Cetinkaya N, Yalcin H et al. Retrospective
evaluation of borderline ovarian tumors: single center
experience of 183 cases Arch Gynecol Obstet 2015;
291:123–130.
- 8. Heintz AP, Odicino F, Maisonneuve P et al. Carcinoma
of the ovary. FIGO 26th Annual Report on the Results of
Treatment in Gynecological Cancer. Int J Gynaecol Obstet
2006;95:S161–S192.
- 9. Van Leeuwen FE, Klip H, Mooij TM et al. Risk of borderline
and invasive ovarian tumours after ovarian stimulation
for in vitro fertilization in a large Dutch cohort.Hum
Reprod 2011;26:3456 –3465.
- 10. Tropé C, Davidson B, Paulsen T et al. Diagnosis and treatment
of borderline ovarian neoplasms ‘the state of the
art’. Eur J Gynaecol Oncol 2009; 30: 471–482.
- 11. Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis,
Treatment, and Follow-Up of Borderline Ovarian Tumors.
The Oncologist 2012;17:1515–1533.
- 12. Tropé CG, Kaern J et al. Borderline ovarian tumours.
Best Practice & Research Clinical Obstetrics and Gynaecology
26 2012; 325–336
- 13. Camilla F. Gosvig, Susanne K. Kjaer, Jan Blaak Æ R et al.
Coffee, tea, and caffeine consumption and risk of epithelial
ovarian cancer and borderline ovarian tumors: Results
from a Danish case-control study. Acta Oncologica,
2015; Early Online: 1–8.
- 14. Harter P, Gershenson D, Lhomme C et al.Gynecologic
Cancer InterGroup (GCIG) Consensus Review for Ovarian
Tumors of Low Malignant Potential (Borderline
Ovarian Tumors). International Journal of Gynecological
Cancer & Volume. 2014; 24, Number S3, November.
- 15. Song T, Lee YY, Choi CH, Kim TJ et al. Borderline ovarian
tumor in women aged _65 years: impact on recurrence
and survival. European Journal of Obstetrics &
Gynecology and Reproductive Biology 184 2015; 38–42
- 16. du Bois A, Ewald-Riegler N, de Gregorio N, et al. Borderline
tumours of the ovary: a cohort study of the Arbeitsgemeinschaft
Gyna¨kologische Onkologie (AGO) Study
Group. Eur J Cancer. 2013; 49:1905-1914.
- 17. Tinelli R, Tinelli A, Tinelli FG et al. Conservative surgery
for borderline ovarian tumors: A review. Gynecol Oncol
2006;100:185–191.
- 18. du Bois A, Ewald-Riegler N, du Bois O et al. Borderline
tumors of the ovary: A systematic review. Geburtsh Frauenheilk
2009;69:807– 833.
- 19. Trillsch F, Mahner S, Ruetzel J et al. Clinical management
of borderline ovarian tumors. Expert Rev Anticancer
Ther 2010; 10:1115–1124.
- 20. Cadron I, Leunen K, Van Gorp T et al. Management of
borderline ovarian neoplasms. J Clin Oncol 2007; 25:
2928–2937.
- 21. Bjørge T, Engeland A, Hansen S et al. Prognosis of patients
with ovarian cancer and borderline tumours diagnosed
in Norway between 1954 and 1993. Int J Cancer
1998; 75: 663–670.
- 22. C. Uzan, E. Muller, A. Kane et al. Prognostic factors for
recurrence after conservative treatment in a series of 119
patients with stage I serous borderline tumors of the
ovary
Annals of Oncology 25: 166–171 Published online 2013;
28 November.
- 23. Oedegaard E. Ovarian carcinomas and borderline ovarian
tumors - molecular markers and operative treatment.
Dissertation, Facutly of Medicine, University of Oslo,
2008.
- 24. Loizzi V, Selvaggi L, Leone L et al. Borderline epithelial
tumors of the ovary: Experience of 55 patients. Oncology
Letters 2015; 9: 912-914.
- 25. Morice P. Borderline tumours of the ovary and fertility.
Eur J Cancer 2006;42:149 –158.
- 26. Coumbos A, Sehouli J, Chekerov R, et al. Clinical management
of borderline tumours of the ovary: results of a
multicentre survey of 323 clinics in Germany. Br J Cancer.
2009;100:1731-1738.
- 27. Baker P, Oliva E. A practical approach to intraoperative
consultation in gynecological pathology. Int J Gynecol
Pathol. 2008;27:353-365.
- 28. Van Calster B, Van Hoorde K, Valentin L et al. International
Ovarian Tumour Analysis (IOTA) group Evaluating
the risk of ovarian cancer before surgery using the ADNEX
model to differentiate between benign, borderline,
early and advanced stage invasive, and secondary metastatic
tumours: prospective multicentre diagnostic study
BMJ 2014;349:g5920.
- 29. Van Gorp T, Veldman J, Van Calster B et al. Subjective
assessment by ultrasound is superior to the risk of malignancy
index (RMI) or the risk of ovarian malignancy
algorithm (ROMA) in discriminating benign from malignant
adnexal masses. Eur J Cancer 2012;48:1649–1656.
- 30. Seidman JD, Horkayne-Szakaly I, Haiba M et al. The histologic
type and stage istribution of ovarian carcinomas
of surface epithelial origin. Int J Gynecol Pathol 2004;
23: 41–44.
- 31. Turan T, Cirik DA et al. Frozen section in borderline ovarian
tumors: is it reliable? Eur J Obstet Gynecol Reprod
Biol. 2014 Oct;181:115-8.