Clinical significance of surgical staging and lymphadenectomy in patients with borderline ovarian tumors

Chang, Suk Joon; Ji, Yong Il; Yoon, Jun; Kim, Dae Yeon; Suh, Dae Shik; Kim, Jong Hyeok; Kim, Yong Man; Kim, Young Tak; Nam, Joo Hyun; Mok, Jung Eun

Abstract

OBJECTIVE
To compare the outcome of patients with borderline ovarian tumors who had been surgically staged with those who were not staged.
METHODS
Between 1997 and 2004, there were 204 patients who underwent surgery and were diagnosed as borderline ovarian tumors. A retrospective review was performed. Two groups were identified: patients who underwent surgical staging (n=98) versus those who were not staged (n=106). Clinical outcomes were compared between the two groups.
RESULTS
Between the two groups, there were no differences of the mean age of the time of diagnosis, parity, BMI, family history, pretreatment CA 125 level, tumor size, and disease recurrence, but were significant differences of FIGO stage (p=0.04), histologic types (p<0.01), operation time (p<0.01), length of hospital stay (p<0.01), and adjuvant chemotherapy (p<0.01). The lymph node positivity rate were 3.5% and 7.1% in patients with pelvic and para-aortic lymphadenectomy respectively. All patients with postive lymph nodes showed the micropapillary serous carcinoma. The 5 year disease-free survival rate was 90%. The overall disease-free survival was significantly found to be decreased in patients with advanced FIGO stage (p<0.01). There was no significant difference of overall disease-free survival regard to pretreatment CA 125 level (p=0.72), histologic types (p=0.78), adjuvant chemotherapy (p=0.45), and surgical staging with lymphadenectomy (p=0.79).
CONCLUSION
Disease-free survival was not significantly different between staged and unstaged patients who had surgery with borderline ovarian tumors. It seems that routine pelvic and para-aortic lymphadenectomy is not necessary in the majority of women with borderline ovarian tumors.