title: Borderline tumours of the ovary: A cohort study of the Arbeitsgmeinschaft Gynäkologische Onkologie (AGO) Study Group.
abstract: BACKGROUND
  Borderline ovarian tumours (BOTs) are recognised as a unique entity of ovarian tumours that do not exert infiltrative destructive growth or stromal invasion. Prognosis of BOT is much better compared to the more common invasive epithelial ovarian cancer. Information regarding prognostic factors is inconclusive and no prospective studies exist that evaluate therapeutic strategies. We therefore started a retrospective-prospective cohort study to better understand BOT and identify scenarios in which future studies could be developed.
  
  
  METHODS
  Consecutive patients with BOT treated between 1998 and 2008 in 24 German centres were analysed. The retrospective part of the study retrieved patients' data from hospital records and clinical tumour registries while active follow-up and an independent central pathology review were carried out prospectively.
  
  
  RESULTS
  BOT was confirmed in 950 patients, two thirds had serous BOT and 30.5% mucinous BOT. Most were diagnosed in stage I (82.3%); 7.6% and 10.1% had stages II and III, respectively. Overall, 74 patients (7.8%) experienced relapse and 43 (4.5%) died within the observation period. Multivariate analysis revealed higher stage, incomplete staging, tumour residuals, and organ preservation as independent prognostic factors for disease recurrence. Neither microinvasion nor micropapillary growth pattern showed any significant impact. Of 74 relapsed patients, 30% had malignant transformation to invasive ovarian cancer with five-year progression-free survival and overall survival of 12% and 50%, respectively.
  
  
  CONCLUSIONS
  Prognosis of BOT correlates with tumour-related as well as surgery-related factors. The balance between recurrence risk and organ preservation and fertility-sparing surgery is an important issue deserving further research.
authors.affiliation: Gynäkologie & Gynäkologische Onkologie, Kliniken Essen-Mitte, Essen, Germany. prof.dubois@googlemail.com
authors.forename: Andreas
authors.initials: A
authors.lastname: du Bois
authors.forename: Nina
authors.initials: N
authors.lastname: Ewald-Riegler
authors.forename: Nikolaus
authors.initials: N
authors.lastname: de Gregorio
authors.forename: Alexander
authors.initials: A
authors.lastname: Reuss
authors.forename: Sven
authors.initials: S
authors.lastname: Mahner
authors.forename: Christina
authors.initials: C
authors.lastname: Fotopoulou
authors.forename: Friedrich
authors.initials: F
authors.lastname: Kommoss
authors.forename: Barbara
authors.initials: B
authors.lastname: Schmalfeldt
authors.forename: Felix
authors.initials: F
authors.lastname: Hilpert
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
authors.forename: Alexander
authors.initials: A
authors.lastname: Burges
authors.forename: Werner
authors.initials: W
authors.lastname: Meier
authors.forename: Peter
authors.initials: P
authors.lastname: Hillemanns
authors.forename: Lars
authors.initials: L
authors.lastname: Hanker
authors.forename: Annette
authors.initials: A
authors.lastname: Hasenburg
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Strauss
authors.forename: Martin
authors.initials: M
authors.lastname: Hellriegel
authors.forename: Pauline
authors.initials: P
authors.lastname: Wimberger
authors.forename: Mignon-Denise
authors.initials: MD
authors.lastname: Keyver-Paik
authors.forename: Klaus
authors.initials: K
authors.lastname: Baumann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Canzler
authors.forename: Kerstin
authors.initials: K
authors.lastname: Wollschlaeger
authors.forename: Dirk
authors.initials: D
authors.lastname: Forner
authors.forename: Jacobus
authors.initials: J
authors.lastname: Pfisterer
authors.forename: Willibald
authors.initials: W
authors.lastname: Schröder
authors.forename: Karsten
authors.initials: K
authors.lastname: Münstedt
authors.forename: Barbara
authors.initials: B
authors.lastname: Richter
authors.forename: Stefan
authors.initials: S
authors.lastname: Kommoss
authors.forename: Steffen
authors.initials: S
authors.lastname: Hauptmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010053:Ovary / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D016016:Proportional Hazards Models; D055815:Young Adult