title: Laparoscopic restaging of borderline ovarian tumours (BLOT): a retrospective study of 142 cases.
abstract: OBJECTIVE
  
  
  
  OBJECTIVE
  To analyse the impact of restaging, on recurrences and survival, in BLOT.
  
  
  OBJECTIVE
  To cluster patients who could be exempted from restaging.
  
  
  METHODS
  This retrospective study, included patients operated for a BLOT, between January 1990, and December 2007, in gynaecological surgery units of the University Hospital of Clermont-Ferrand. Two groups were evaluated: patients with and without optimal restaging.
  
  
  RESULTS
  One hundred and forty-two patients were included. Optimal initial staging rate was 38.7% (n=55). Among the eighty-seven women not initially staged, two groups were compared: restaged (n=45) and non-restaged patients (n=42). Mean follow-up was 80.5 months. Overall survival was 93.7%. Relapse rate was 7.7% (n=11). Disease free survival (DFS) was 88% after a mean follow-up of 80.5 months. One death was noted. Optimal restaging rate was 31.7% (n=45, 43 by laparoscopy). Mean follow-up was of 87.1 months among restaged patients, 84.5 months among non-restaged patients (p=0.93). Relapse incidence was significantly higher in non restaged, than in restaged patients (p=0.008). DFS was significantly longer among restaged than non-restaged patients, (p=0.072). Younger age (p=0.04), conservative treatment (p<10(-4)) or non-diploidy (p=0.04) increased the incidence of relapse.
  
  
  CONCLUSIONS
  When initial staging is missing, restaging improves the patients outcome in comparison to non-restaged groups. Laparoscopy is a valuable surgical option. This study suggests that a selected group of patients, older than 30 years old, submitted to a radical treatment, presenting a diploid, non micropapillar, mucinous BLOT, without visible implants during careful peritoneal inspection, could be exempted from restaging. They represented 11.6% of our population.
authors: Department of Obstetrics and Gynaecology, Universitary Hospital Estaing, Clermont-Ferrand, France. asazuar@gmail.com
authors: A S
authors: AS
authors: Azuar
authors: N
authors: N
authors: Bourdel
authors: G
authors: G
authors: Ferrarrese
authors: J
authors: J
authors: Dauplat
authors: G
authors: G
authors: Mage
authors: M
authors: M
authors: Canis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies