title: Prognostic factors and survival of borderline ovarian tumors in Rajavithi Hospital between 1979-2006 A.D.
abstract: OBJECTIVE
  Evaluate 5-year progression-free survival, 5-year disease-specific survival, and prognostic factors for recurrence and survival in patients with borderline ovarian tumors in Rajavithi Hospital.
  
  
  METHODS
  A retrospective study of the patients with borderline ovarian tumors who were treated at Rajavithi Hospital before 2006 was performed Patients 'clinical characteristics, detail of treatment and all variables that seemed to influence survival or recurrence of disease and patients' life status were obtained from gynecologic oncologic files, medical record documents, and National Population Statistic Office Database
  
  
  RESULTS
  Two hundred ten patients were enrolled in the present study. Nearly 90% (187 patients, 89%) had stage I disease. Another seven (3.3%) were in stage II, 15 (7.2%) in stage III, and one (0.5%) in stage IV. The most common histology was mucinous (157 patients, 74.8%), followed by serous (49 patients, 23.3%) and mixed serous and mucinous (4 patients, 1.9%). The mean age of the patients was 41 years (range, 14 to 82 years). The mean size of tumor was 17 cm (range, 5 to 40 cm). The majority of primary treatment was by surgery only at approximately 87.6% (184 patients) and the remaining 12.4% (26 patients) was surgery plus adjuvant chemotherapy. Bilateral ovarian involvement was found in 13 patients (6.2%). Twenty-three percent of patients with peritoneal implants had bilateral ovarian involvement whereas the rate in the group without peritoneal implants was 5.7%. The 5-year progression-free survival (PFS) and 5-year disease-specific interval (DSS) were 92.32% and 95.72% respectively. Nine patients (4.3%) had recurrence of disease and 11 (5.2%) died of disease. Salvage therapy mainly was surgery and three patients (33%) were cured without evidence of disease. Univariate analysis showed two significant prognostic factors for PFS. Those were stage of disease and optimal debulking. The four significant prognostic factors for DSS were stage of disease, optimal debulking, rupture of tumor and presence of ascites. Conservative surgery, incomplete staging, lymphadenectomy, periovarian adhesion, or positive peritoneal cytology did not seem to influence PFS and DSS. Independent prognostic factor for PFS and DSS could not be conclusively drawn by multivariate analysis because of far too few death and recurrence events in the present study.
  
  
  CONCLUSIONS
  The borderline ovarian tumors had an excellent prognosis. Conservative surgery should be carried out in women at reproductive age with early stage of disease who have fertility desire.
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics & Gynecology, Rajavithi Hospital, Bangkok, Thailand. chanapatman@gmail.com
authors.forename: Somboon
authors.initials: S
authors.lastname: Sornsukolrat
authors.forename: Suphet
authors.initials: S
authors.lastname: Tuipae
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult