title: Systematic evaluation of the intraoperative tumor pattern in patients with borderline tumor of the ovary.
abstract: OBJECTIVE
  Borderline ovarian tumors (BOTs) are rare entities with excellent prognosis depending on tumor stage and presence of invasive implants. There are limited data regarding the intraoperative tumor pattern, the actual base of optimal treatment planning. We conducted a systematic evaluation of the macroscopic and microscopic tumor spreads in patients with BOTs with special focus on the diagnosis of invasive and noninvasive lesions.
  
  
  METHODS
  Between January 2001 and July 2008, data of patients with BOTs were evaluated using a systematic and validated documentation tool (intraoperative mapping of ovarian cancer). Surgical outcome and pathological findings were analyzed.
  
  
  RESULTS
  Fifty-one patients underwent surgery for BOT. Mean (SD) age was 47.76 (15.9) years. In 6 patients (11.8%), surgery was performed for recurrence. Complete tumor resection was achieved in 47 patients (92.15%), whereas mean (SD) operative time was 126.34 (73.4) minutes. Pathologic evaluation identified 12 patients (23.53%) with mucinous and 39 patients (76.47%) with serous histologic diagnoses. Twenty-nine (56.86%) and 22 patients (43.13%) were found to have unilateral and bilateral ovarian involvements, respectively. Sixteen patients (31.37%) presented extraovarian involvement into the peritoneum (23.5%), omentum (17.7%), uterus (7.84%), sigmoid (7.8%), lymph nodes (7.8%), ileum (3.9%), mesentery (5.9%), and appendix (1.96%). Twenty patients (39.2%) had implants; of those, 9 (17.64%) and 11 patients (21.6%) have invasive and noninvasive lesions, respectively. Eight of the 9 patients with positive peritoneal cytology were associated with the presence of peritoneal implants; 3 of them with invasive character.
  
  
  CONCLUSIONS
  Borderline ovarian tumors require a systematic surgical evaluation to verify or exclude extrapelvic tumor lesions and allow further clinical relevant differentiation between invasive and noninvasive implants.
authors: Department of Gynecology and Obstetrics, Charité University Hospital, Campus Virchow-Clinic, Berlin, Germany. christina.fotopoulou@charite.de
authors: Christina
authors: C
authors: Fotopoulou
authors: Guido
authors: G
authors: Schumacher
authors: Joerg C
authors: JC
authors: Schefold
authors: Carsten
authors: C
authors: Denkert
authors: Werner
authors: W
authors: Lichtenegger
authors: Jalid
authors: J
authors: Sehouli
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008643:Mesentery / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D008954:Models, Biological; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging / Q000379:methods*; D009852:Omentum / Q000473:pathology / Q000601:surgery; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D010053:Ovary / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies