title: Outcome of patients with advanced-stage borderline ovarian tumors after a first peritoneal noninvasive recurrence: impact on further management.
abstract: OBJECTIVE
  The aims of this study were to report the outcome of patients with advanced-stage serous borderline ovarian tumors (SBOT) after a first noninvasive recurrence and the impact of conservative treatment in that context and to define the best management for those patients.
  
  
  METHODS
  From 1973 to 2006, 168 patients were treated at or referred to our institution for an SBOT with peritoneal implants. Their slides were reviewed by the same expert pathologist. Selection criteria were as follows: advanced stage (International Federation of Gynecology and Obstetrics ≥ II), with at least 1 recurrence (only noninvasive ones) and more than 5 years of follow-up.
  
  
  RESULTS
  Twenty patients met the inclusion criteria. The median duration of follow-up was 12 years (range, 6-23 years). Median age was 26 years (14-61 years). Initial surgical management was conservative for 14 patients and radical for 6. In the study population, 4 patients recurred, all with invasive disease. Time to invasive recurrence was at least 3 years for 3 of 4 patients. None of those 4 patients had a second-look surgery initially or after the first recurrence. Two patients had small-sized residual disease after initial management; only 1 of these 4 patients is currently alive and disease-free. There was no significant difference between conservative and radical treatment of the risk of second recurrence.
  
  
  CONCLUSIONS
  This study emphasizes the need for a long follow-up after recurrence of advanced-stage SBOT and the risk of a new invasive recurrence after a first noninvasive peritoneal recurrence. Conservative treatment does not seem as a risk factor and is still justified after a first noninvasive recurrence for young patients who desire to preserve fertility.
authors.affiliation: Departments of *Gynecologic Surgery, †Oncology, and ‡Pathology, §University Paris Sud, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Uzan
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Zanini-Grandon
authors.forename: Enrica
authors.initials: E
authors.lastname: Bentivegna
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gouy
authors.forename: Alexandra
authors.initials: A
authors.lastname: Leary
authors.forename: Pierre
authors.initials: P
authors.lastname: Duvillard
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D018284:Cystadenocarcinoma, Serous / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult