Ganim Khatib, MD Çukurova University Gynecological Oncology Five Years Single Institution Retrospective Analysis of the Borderline Ovarian Tumors Ghanim Khatib, Ümran Küçükgöz Güleç, Ahmet Barış Güzel, Emine Bağır, Mete Sucu, Mehmet Özsürmeli, Cihan Çetin, Mehmet Ali Vardar Ganim Khatib, MD Çukurova University Gynecological Oncology

Introduction Borderline ovarian tumors (BOTs) are characterized with atypical epithelial proliferation without stromal invasion They comprise about 10–15% of primary epithelial ovarian neoplasms. Compared with epithelial ovarian carcinomas (EOCs), BOTs are usually determined at early stages and presented in premenopausal women.

Introduction Surgery is the mainstay of the treatment and frequently curable with excellent prognosis. The aim of this study was to evaluate the borderline ovarian tumor cases who were operated in our clinic.

Material and Methods This study was conducted at the Gynecologic Oncology Department of Çukurova University Medical Hospital in Adana, Turkey. The study was approved by The Research Ethics Committee of Çukurova University.

Material and Methods Gynecologic Oncology archival files, computer records and pathology reports were retrospectively reviewed for the borderline ovarian tumor patients who were treated between 01 January 2010 and 30 December 2015.

Material and Methods A total of 41 cases were detected and included in the study. Patients’ demographic characteristics, preoperative assessments, operation and pathological features were evaluated.

Results Patients’ mean age was 41 and 85% of them were premenopausal. Average of the tumor diameter was found to be 10cm in the preoperative ultrasound examination. Mean of the preoperative ca125 value was 120.

Parametre ortalama±SD Aralık N (%) Yaş 41,5±15 17-88 Menopoz durumu Premenopoz 35 (85,4) Tumor çapı (cm) 10±4,5 2,5-23 Postmenopoz 6 (14,6) Ca125 120±25 9-1371 Septa formasyonu Yok 27 (65,9)   Var 14 (34,1) Papillar projeksiyon 15 (36,6) 26 (63,4) Asit varlığı 23 (56,1) 18 (43,9) Cerrahi prosedür TH-BSO 12 (29,3) USO 29 (70,7) Omentektomi 25 (61,0) 16 (39,0) lenfadenektomi 24 (58,5) 17 (41,5) Tümörün lokalizasyonu Sağ 19 (%46,3) Sol (%34,1) Bilateral 8 (%19,5) Histopatolojik tip Seröz Müsinöz 11 (26,8) Seromüsinöz 1 (2,4) Evre IA 32 (%78) IB (0) IC 5 (%12,2) II (%2,4) III 3 (%7,3) IV

Results While total hysterectomy + bilateral salpingo-oophorectomy (TH-BSO) was applied to 12 cases, unilateral salpingo-oophorectomy (USO) was performed in the remaining 29 patients. Pelvic paraaortic lymphadenectomy was carried out in 41.5% of the patients.

Results Serous borderline was the most common histology (70.7%). Majority of the cases was with stage I disease (90.2%). No recurrences were determined among the study population.

Discussion BOTs, often affect women in reproductive age. Hence, fertility-sparing surgery such as cystectomy or USO is very important for these patients. Whereas TH-BSO is the appropriate aproach for the peri-postmenopausal ones or those who completed their fertility and prefer radical surgery

Discussion Staging is a controversial subject Pelvic paraaortic lymphadenectomy? Omentectomy? Appendectomy?

Discussion Ca 125 is the most investigated marker Gotlieb et. al. have found that ca125 was elevated in %75 and %30 of serous and mucinous BOT cases, respectively. Interestingly, while serous BOTs are the most common histopathological type in North America, Europe and Middle East, mucinous type is the first in East Asia Our study: serous (%70.7) mucinous %26.8

Conclusion Borderline ovarian tumors have a favorable prognosis and therefore, unilateral salpingo-oophorectomy can be suggested to be a safely treatment approach for patients who desire to protect their fertility.

Conclusion Although patients with conservative surgery have higher recurrence, survival time is not shortened. Extensiveness of surgical staging including lymph node sampling or dissection and appendectomy does not cause any differences on survival rates.