Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan.
Gynecol Oncol. 2019 May;153(2):230-237. doi: 10.1016/j.ygyno.2019.02.003. Epub 2019 Feb 20.
Mucinous borderline ovarian tumor (mucinous-BOT) and invasive well-differentiated mucinous ovarian cancer (mucinous-OC) are often histopathologically misclassified. The objective of this study was to examine differences in clinico-pathological characteristics and outcomes of these two entities.
This is a retrospective population-based study examining the Surveillance, Epidemiology, and End Results Program from 1988 to 2000. Stage I mucinous-BOTs and stage I well-differentiated mucinous-OC were compared for patient demographics, tumor characteristics, and outcomes. Propensity score matching and multivariable analysis were used to assess cause-specific survival (CSS).
A total of 2130 mucinous-BOT and 581 mucinous-OC cases were examined for analysis. On multivariable analysis, women with mucinous-OC were more likely to be older, Eastern U.S. residents, and have undergone hysterectomy or lymphadenectomy compared to those with mucinous-BOT, and the number of women diagnosed with mucinous-OC decreased over time (all, P < 0.05). Mucinous-OCs were more likely to be stage T1c and have a smaller tumor size as compared to mucinous-BOT (both, adjusted-P < 0.05). After propensity score matching, women with mucinous-OC had significantly poorer CSS compared to those with mucinous-BOT on multivariable analysis (10-year rates: 92.7% versus 97.5%, adjusted-hazard ratio [HR] 2.03, P = 0.007). Similar results were observed among subgroups for reproductive age, stage T1a disease, large tumor, and unstaged cases (all, P < 0.05).
Stage I mucinous-BOT and stage I invasive well-differentiated mucinous-OC have distinct differences in clinical characteristics and patient survival. The inability to conduct centralized pathology review in our study limits our conclusions given the recognized issue of misclassification of mucinous-BOT and mucinous-OC, but further highlights the importance of making the proper histopathological diagnosis for invasive cancer when the ovarian tumor is of mucinous histology.
黏液性交界性卵巢肿瘤（mucinous-BOT）和浸润性高分化黏液性卵巢癌（mucinous-OC）在组织病理学上常常被错误分类。本研究的目的是研究这两种实体之间临床病理特征和结局的差异。
这是一项回顾性基于人群的研究，对 1988 年至 2000 年期间的监测、流行病学和最终结果计划（SEER）数据库进行了研究。比较了 I 期黏液性 BOT 和 I 期高分化黏液性 OC 患者的人口统计学特征、肿瘤特征和结局。采用倾向评分匹配和多变量分析评估特定原因的生存率（CSS）。
共分析了 2130 例黏液性 BOT 和 581 例黏液性 OC 病例。多变量分析显示，与黏液性 BOT 相比，黏液性 OC 患者年龄更大，来自美国东部，更有可能接受过子宫切除术或淋巴结切除术，且随着时间的推移诊断为黏液性 OC 的患者数量减少（所有，P<0.05）。与黏液性 BOT 相比，黏液性 OC 更有可能为 T1c 期且肿瘤体积更小（均为调整后 P<0.05）。在倾向评分匹配后，多变量分析显示黏液性 OC 患者的 CSS 明显差于黏液性 BOT 患者（10 年生存率：92.7%对 97.5%，调整后危险比[HR] 2.03，P=0.007）。在生殖年龄、T1a 期疾病、大肿瘤和未分期病例的亚组中也观察到了相似的结果（所有，P<0.05）。
I 期黏液性 BOT 和 I 期浸润性高分化黏液性 OC 在临床特征和患者生存方面存在明显差异。由于认识到黏液性 BOT 和黏液性 OC 分类错误的问题，我们的研究无法进行集中的病理审查，这限制了我们的结论，但进一步强调了在卵巢肿瘤为黏液性组织学类型时做出正确组织病理学诊断对于浸润性癌症的重要性。
