Isala Hospital, Department of Obstetrics and Gynecology, Zwolle, The Netherlands.
Maastricht University Medical Center, Department of Obstetrics and Gynecology, Maastricht, The Netherlands.
Gynecol Oncol. 2017 Feb;144(2):285-289. doi: 10.1016/j.ygyno.2016.11.035. Epub 2016 Nov 23.
Staging in case of a borderline tumor of the ovary (BOT) is a controversial issue. Upstaging is not uncommon, but this occurs especially with presumed stage I serous borderline tumors. There are only a few documented cases of BOTs of non-serous histology that were not confined to the ovary. The aim of this study was to assess the incidence of non-invasive and invasive implants in the omentum and other (extra)pelvic peritoneal surfaces in patients with a mucinous BOT (mBOT).
A retrospective cohort study was performed in three hospitals in the Netherlands. All patients with a histopathological diagnosis of mBOT diagnosed from January 1st 1990 to December 1st 2015 were identified and included when the inclusion criteria were met.
In total, 74 patients were included. Of these 74 patients, 46 (62.2%) underwent a staging procedure. In 12 (26.1%) patients, only omental tissue was obtained, in 32 (69.6%) patients, omental tissue and peritoneal biopsies were obtained and in two (4.3%) patients, only peritoneal biopsies were obtained. No implants were seen upon microscopic examination in any of the patients. Two patients (3%) developed a recurrence.
Because no extra-ovarian disease was found, staging procedures in the case of an mBOT may be omitted. However, the actual perioperative decision for staging or not should be taken in the context of a frozen section diagnosis, which is not always accurate and straightforward. Recurrence with malignant disease is rare after mBOT. The value of post-treatment surveillance seems limited after bilateral salpingo-oophorectomy.
卵巢交界性肿瘤（BOT）的分期是一个有争议的问题。分期升级并不罕见，但这种情况尤其发生在假定的 I 期浆液性交界性肿瘤中。仅有少数非浆液性组织学的 BOT 病例记录在案，这些病例并未局限于卵巢。本研究的目的是评估在具有粘液性 BOT（mBOT）的患者中，大网膜和其他（额外）盆腔腹膜表面有无侵袭性和非侵袭性种植体的发生率。
在荷兰的三家医院进行了回顾性队列研究。所有在 1990 年 1 月 1 日至 2015 年 12 月 1 日期间被诊断为 mBOT 的患者，当符合纳入标准时，均被识别并纳入。
共纳入 74 例患者。其中 46 例（62.2%）患者进行了分期手术。12 例（26.1%）患者仅获得大网膜组织，32 例（69.6%）患者获得大网膜组织和腹膜活检，2 例（4.3%）患者仅获得腹膜活检。在任何患者的显微镜检查中均未发现种植体。2 例（3%）患者复发。
由于未发现卵巢外疾病，因此可能可以省略 mBOT 的分期手术。但是，在进行冷冻切片诊断时，应该根据实际的围手术期情况来决定是否进行分期，而冷冻切片诊断并不总是准确和直接的。mBOT 后发生恶性疾病的复发很少见。在双侧输卵管卵巢切除术后，治疗后监测的价值似乎有限。
