title: Prognostic factors predicting recurrence in borderline ovarian tumors.
abstract: OBJECTIVE
  We aimed to investigate outcome of borderline ovarian tumors (BOTs) with respect to methods and extent of surgical approach and to evaluate prognostic factors.
  
  
  METHODS
  A retrospective study included consecutive patients with BOT treated from 1984 to 2008. These cases were confirmed by histological review. The influence of clinico-pathological characteristics upon recurrence and death were analyzed by independent sample t test, Chi-square test, logistic regression model, and Cox proportional hazard model.
  
  
  RESULTS
  A total of 233 patients were enrolled, 214 in Stage I, 11 Stage II and 8 Stage III. There were 21 relapses, only 5 of which died of disease. 5-year and 10-year overall survival were 97.6% and 96.4%, and recurrence-free survival rates (RFS) were 92.7% and 88.2%, respectively. Median follow-up time for survivors was 81 (range, 0.5-295) months. Median time to recurrence was 31 (range, 5.5-181) months. In multivariate analysis, Stage II/III, cystectomy and higher pretreatment serum CA-125 level (>or=144 U/mL) were selected for a model predicting 5-year RFS, where risk factor=0, 1, and 2-3 had odds ratios of 1, 14.9, and 113.3, respectively (p<0.001). Replacing stage with peritoneal implants, the latter two factors along with invasive peritoneal implants were selected. Of the 5 cases died of disease, all had invasive recurrences. Initial laparoscopic or laparotomy approach had no influence on prognosis.
  
  
  CONCLUSIONS
  Although BOT has an excellent prognosis, they are not exempted from a risk of recurrence. Stage II/III (or invasive implants), cystectomy and higher pre-operative serum CA-125 were independent variables predicting recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 5 Fu-Shin St Kueishan, Taoyuan 333, Taiwan.
authors.forename: Tzu-I
authors.initials: TI
authors.lastname: Wu
authors.forename: Chyi-Long
authors.initials: CL
authors.lastname: Lee
authors.forename: Meng-Yu
authors.initials: MY
authors.lastname: Wu
authors.forename: Swei
authors.initials: S
authors.lastname: Hsueh
authors.forename: Kuan-Gen
authors.initials: KG
authors.lastname: Huang
authors.forename: Chi-Ju
authors.initials: CJ
authors.lastname: Yeh
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018394:CA-125 Antigen