Subclassification of serous borderline tumors of the ovary into benign and malignant types - A clinicopathologic study of 65 advanced stage cases

被引:225
作者
Seidman, JD
Kurman, RJ
机构
[1] ARMED FORCES INST PATHOL, DEPT GYNECOL & BREAST PATHOL, WASHINGTON, DC 20306 USA
[2] JOHNS HOPKINS MED INST, DEPT PATHOL, BALTIMORE, MD 21205 USA
[3] JOHNS HOPKINS MED INST, DEPT OBSTET & GYNECOL, BALTIMORE, MD 21205 USA
关键词
ovarian neoplasms; serous borderline tumor; serous tumor of low malignant potential; serous carcinoma; micropapillary serous carcinoma;
D O I
10.1097/00000478-199611000-00004
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Poor outcome in serous borderline tumors (SBT) of the ovary is limited to patients with advanced stage disease. This study was designed to determine whether there are histologic features among advanced-stage SBTs (International Federation of Gynecology and Obstetrics [FIGO] stages II and III) that predict behavior. The 65 cases in the study were divided into three groups: typical SBTs with noninvasive implants (51 cases), SBTs with invasive implants (three cases), and a recently described tumor, designated micropapillary serous carcinoma (MPSC) (11 cases), a proliferative serous ovarian neoplasm that often lacks destructive infiltrative growth but appears to behave as a low-grade invasive carcinoma. When the tumor lacks infiltrative growth, as it did in the 11 cases in this series, it qualifies as a borderline tumor. After censoring nontumor deaths, the 5- and 10-year actuarial survival rates were 98% for SBTs with noninvasive implants, 33% for SBTs with invasive implants, and 81% at 5 years and 71% at 10 years for MPSCs. The mean follow-up was 100 months. Two (4%) of 51 patients with SBTs with noninvasive implants subsequently developed invasive carcinoma, and one (2%) died of carcinoma. In contrast, two (67%) of three women with SBTs accompanied by invasive implants developed invasive carcinoma, and both died of disease. Finally, of the 11 patients with MPSC, seven (64%), all of whom had invasive implants, developed recurrences of invasive carcinoma and/or died of tumor. MPSCs had significantly higher rates of mortality (p < 0.001) and recurrence as invasive carcinoma (p < .002) than SBTs with noninvasive implants. The recognition that SBTs can be divided into benign and malignant subtypes provides the basis for replacing the borderline category. The benign subgroup is composed of typical SBTs, including those with noninvasive implants for which the atypical proliferative serous tumor is appropriate. In contrast, tumors displaying a micropapillary growth pattern (MPSC) and SBTs with invasive implants should be classified as carcinomas and treated accordingly.
引用
收藏
页码:1331 / 1345
页数:15
相关论文
共 54 条
[1]  
[Anonymous], 1971, Acta Obstet Gynecol Scand, V50, P1
[2]  
BARNHILL D, 1985, OBSTET GYNECOL, V65, P53
[3]   PRELIMINARY-ANALYSIS OF THE BEHAVIOR OF STAGE-I OVARIAN SEROUS TUMORS OF LOW MALIGNANT POTENTIAL - A GYNECOLOGIC-ONCOLOGY-GROUP STUDY [J].
BARNHILL, DR ;
KURMAN, RJ ;
BRADY, MF ;
OMURA, GA ;
YORDAN, E ;
GIVEN, FT ;
KUCERA, PR ;
ROMAN, LD .
JOURNAL OF CLINICAL ONCOLOGY, 1995, 13 (11) :2752-2756
[4]   SEROUS BORDERLINE TUMORS OF THE PERITONEUM [J].
BELL, DA ;
SCULLY, RE .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1990, 14 (03) :230-239
[5]  
BELL DA, 1988, CANCER, V62, P2212, DOI 10.1002/1097-0142(19881115)62:10<2212::AID-CNCR2820621024>3.0.CO
[6]  
2-W
[7]   OVARIAN SEROUS BORDERLINE TUMORS WITH STROMAL MICROINVASION - A REPORT OF 21 CASES [J].
BELL, DA ;
SCULLY, RE .
HUMAN PATHOLOGY, 1990, 21 (04) :397-403
[8]   PERITONEAL SEROUS MICROPAPILLOMATOSIS OF LOW MALIGNANT POTENTIAL (SEROUS BORDERLINE TUMORS OF THE PERITONEUM) - A CLINICOPATHOLOGICAL STUDY OF 17 CASES [J].
BISCOTTI, CV ;
HART, WR .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1992, 16 (05) :467-475
[9]   EXTRAOVARIAN PERITONEAL SEROUS PAPILLARY CARCINOMA - A CASE-CONTROL RETROSPECTIVE COMPARISON TO PAPILLARY ADENOCARCINOMA OF THE OVARY [J].
BLOSS, JD ;
LIAO, SY ;
BULLER, RE ;
MANETTA, A ;
BERMAN, ML ;
MCMEEKIN, S ;
BLOSS, LP ;
DISAIA, PJ .
GYNECOLOGIC ONCOLOGY, 1993, 50 (03) :347-351
[10]  
BOSTWICK DG, 1986, CANCER, V58, P2052, DOI 10.1002/1097-0142(19861101)58:9<2052::AID-CNCR2820580916>3.0.CO