title: Improving the clinical management of women with borderline tumours: a recurrence risk scoring system from a French multicentre study.
abstract: OBJECTIVE
  To develop a risk scoring system (RSS) for predicting recurrence in women with borderline ovarian tumours (BOTs).
  
  
  METHODS
  Cohort study of women with BOTs.
  
  
  METHODS
  French multicentre tertiary care centres.
  
  
  METHODS
  A cohort of 360 women with BOTs who received primary surgical treatment between January 2000 and December 2013.
  
  
  METHODS
  Clinical and pathological factors affecting recurrence in women with BOTs.
  
  
  METHODS
  The development of a model for the prediction of recurrence in women with BOTs.
  
  
  RESULTS
  Overall the recurrence rate was 20.0% (72/360). Recurrence was associated with five variables: age < 45 years; preoperative serum tumour marker CA125 > 150 IU/mL; a serous histological subtype; International Federation of Gynecology and Obstetrics (FIGO) stage other than IA; and ovarian surgery other than bilateral salpingo-oophorectomy (BSO; i.e. cystectomy and unilateral salpingo-oophorectomy). These variables were included in the RSS and assigned scores ranging from 0 to 6. The discrimination of the RSS was 0.82 (95% confidence interval, 95% CI 0.79-0.85). A total score of 8 points corresponded to the optimal threshold of the RSS, with a rate of recurrence of 11.8% (35/297) and 58.7% (37/63) for women at low risk (<8 points) and women at high risk (≥8 points), respectively. The diagnostic accuracy was 85.0%.
  
  
  CONCLUSIONS
  This study shows that the risk of BOT recurrence can be accurately predicted so that women at high risk can benefit from adapted surgical treatment.
  
  
  CONCLUSIONS
  Our RSS permitted women with BOTs at low risk to be distinguished from women with BOTs at high risk of recurrence.
authors.affiliation: Department of Gynaecology, Centre Hospitalier Universitaire de Tours, Tours, France.|INSERM U1069, Université François-Rabelais, Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: Ouldamer
authors.affiliation: Department of Obstetrics and Gynaecology, Hôpital Tenon, Paris, France.|UMR S 707, Epidemiology, Information Systems, Modelling, Université Pierre et Marie Curie, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Bendifallah
authors.affiliation: Department of Obstetrics and Gynaecology, Hôpital Tenon, Paris, France.|UMR S 707, Epidemiology, Information Systems, Modelling, Université Pierre et Marie Curie, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Nikpayam
authors.affiliation: Department of Gynaecology, Centre Hospitalier Universitaire de Tours, Tours, France.|INSERM U1069, Université François-Rabelais, Tours, France.
authors.forename: G
authors.initials: G
authors.lastname: Body
authors.affiliation: Department of Obstetrics and Gynaecology, Faculté de Médecine et Pharmacie, CHU de Poitiers, Université de Poitiers, Poitiers, France.|INSERM CIC 1402, CHU de Poitiers, Poitiers, France.
authors.forename: X
authors.initials: X
authors.lastname: Fritel
authors.affiliation: Department of Gynaecological Surgery, Institut Gustave Roussy, Villejuif, France.|INSERM U 10-30, Institut Gustave Roussy, Villejuif, France.
authors.forename: C
authors.initials: C
authors.lastname: Uzan
authors.affiliation: Department of Gynaecological Surgery, Institut Gustave Roussy, Villejuif, France.|INSERM U 10-30, Institut Gustave Roussy, Villejuif, France.
authors.forename: P
authors.initials: P
authors.lastname: Morice
authors.affiliation: Department of Obstetrics and Gynaecology, Hôpital Tenon, Paris, France.|INSERM UMR S 938, Université Pierre et Marie Curie, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Daraï
authors.affiliation: Department of Obstetrics and Gynaecology, Hôpital Tenon, Paris, France.|INSERM UMR S 938, Université Pierre et Marie Curie, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Ballester
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D016208:Databases, Factual; D005260:Female; D005602:France; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy / Q000706:statistics & numerical data; D010053:Ovary / Q000473:pathology / Q000601:surgery; D011230:Precancerous Conditions / Q000473:pathology*; D011237:Predictive Value of Tests; D057234:Preoperative Period; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Borderline ovarian tumours; fertility-sparing surgery; recurrence; risk scoring system