Adjuvant platinum-based chemotherapy for borderline serous ovarian tumors with invasive implants.
BACKGROUND
Most borderline ovarian tumors (BOTs) are cured with surgery. However BOTs with invasive implants have a poor prognosis with a mortality of 20-40%. The benefit of adjuvant chemotherapy (CT) in this setting remains poorly defined.


METHODS
Retrospective study of serous BOT+invasive implants treated with adjuvant CT.


RESULTS
36 patients were referred with serous BOTs+invasive implants and treated with surgery and platinum-based CT between 06/1982 and 02/2011. 83% were stage III/IV. Tumors demonstrated microinvasion, micropapillary pattern or desmoplastic implants in 53%, 47% and 67% of cases, respectively. 8% had fertility-sparing surgery. Taking into account initial and completion surgeries, R0 was achieved in 84% (27/32) (NA, N=4). The majority (72%) received a combination of platinum+taxane. 11% of patients experienced a G3/G4 toxicity. 13 of 36 (36%) patients relapsed at a median of 27.3 months after diagnosis of invasive implants. Among 12 patients with histologically confirmed relapse, 8 patients progressed with invasive disease in the form of carcinoma or invasive implants. 5 year PFS/OS were 67%/96%. Neither microinvasion, micropapillary pattern, nor desmoplastic implants predicted relapse. In cases with evaluable disease, an objective response to chemotherapy was observed in 4 of 6 patients.


CONCLUSIONS
This is the largest study of BOT with invasive implants treated with surgery and adjuvant platinum-based CT. Treatment was well tolerated and the invasive relapse rate was 22% (8/36). Although numbers are small, the objective responses suggest a possible role for adjuvant CT in BOTs with invasive implants.
Department of Medicine, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France. Electronic address: Alexandra.leary@igr.fr.
Alexandra
A
Leary
Department of Medicine, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Marie Christina
MC
Petrella
Department of Medicine, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Patricia
P
Pautier
Department of Pathology, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Pierre
P
Duvillard
Department of Surgery, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Catherine
C
Uzan
Department of Medicine, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Youssef
Y
Tazi
Department of Medicine, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Florence
F
Ledoux
Department of Surgery, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Sébastien
S
Gouy
Department of Surgery, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Philippe
P
Morice
Department of Medicine, Gynecology Unit, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
Catherine
C
Lhommé
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D010984:Platinum / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D010984:Platinum
Adjuvant chemotherapy; Invasive implants; Serous borderline ovarian tumor