Prognostic significance of the micropapillary pattern in patients with serous borderline ovarian tumors.

Abstract

BACKGROUND: The impact of micropapillary histology on survival in patients with serous borderline ovarian tumors is not established. The purpose of this study was to evaluate the significance and influence of micropapillary pattern on clinical outcome of patients with serous borderline ovarian tumors.

METHODS: Eighty-five patients who underwent surgery and were diagnosed with serous borderline ovarian tumors were retrospectively studied. Among these patients, 18 patients showed micropapillary pattern on histologic examination, while the remaining 67 patients did not. The significance of the presence of micropapillary pattern and relationship with various clinicopathologic findings and progression-free survival were evaluated by statistical analysis.

RESULTS: No differences with regard to age, parity, body mass index, pretreatment CA-125 level, tumor size, bilaterality, and the duration of follow-up were observed between the two groups, but there was a significant difference in terms of FIGO stage (p<0.001), invasive implants (p=0.004), performing lymphadenectomy (p=0.009), operation time (p=0.003), estimated blood loss (p<0.001), residual disease>1 cm (p=0.001), adjuvant chemotherapy (p<0.001), and the length of hospital stay (p=0.013). Progression-free survival was found to be significantly decreased in patients with invasive implants (HR, 5.06; p=0.025) and micropapillary pattern (HR, 4.20; p=0.056) on multivariate analysis.

CONCLUSIONS: Micropapillary serous borderline ovarian tumors were associated with a more aggressive clinical course compared with typical serous borderline ovarian tumor. The presence of invasive implants and micropapillary pattern were significant prognostic factors in patients with serous borderline ovarian tumors.