title: Malignant and borderline epithelial ovarian tumors in the pediatric and adolescent population.
abstract: OBJECTIVE
  Malignant and borderline ovarian tumors of epithelial origin are rarely encountered among prepubertal girls and adolescents. The aim of this population-based study was to elucidate their clinicopathological characteristics and prognosis using a multi-institutional tumor registry.
  The National Cancer Institute's Surveillance, Epidemiology, and End Results database was accessed and a cohort of females aged <=19years old, diagnosed between 1988 and 2013 with a borderline ovarian tumor (BOT) or a malignant epithelial ovarian carcinoma (EOC) was accessed. Observed survival (OS) was assessed using the Kaplan-Meier method. Comparisons were made using the log-rank test.
  
  
  RESULTS
  A total of 114 cases diagnosed with BOT between 1988 and 2000 were identified; 61/114 (53.5%) and 51/114 (44.8%) of BOT were of serous or mucinous histology respectively. Ten-year OS for those with BOT was 97.3%. A total of 140 cases of EOC were identified. Median age was 17 years and the most common histological subtypes were mucinous 79/140 (56.4%) and serous 29/140 (20.7%) adenocarcinoma. Most had stage I disease 92/131 (70.2%) and fertility-sparing surgery was commonly performed. Five-year OS for those with stage I disease was 93.6% compared to 48.3% for cases with exta-ovarian tumor spread (p<0.001).
  
  
  CONCLUSIONS
  BOT and EOC are exceedingly rare in the pediatric and adolescent population. In this age group EOC consists mostly of low-grade mucinous and serous tumors confined to the ovary. OS survival for those with stage I disease is excellent.
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA. Electronic address: din2004@med.cornell.edu.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Nasioudis
authors.affiliation: Department of Medicine, Warren Alpert Medical School of Brown University, RI, USA.
authors.forename: Michail
authors.initials: M
authors.lastname: Alevizakos
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Holcomb
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Witkin
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D053208:Kaplan-Meier Estimate; D009367:Neoplasm Staging; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate; D055815:Young Adult
keywords: Adolescent; Borderline tumors; Mucinous adenocarcinoma; Ovarian neoplasms; Ovary; Serous cystadenocarcinoma