BOT: risks of recurrence?

It’s what we fear the most: recurrence, or occurrence of a higher-grade (typical) ovarian cancer.  

We know, from existing evidence, that completion surgery is the most effective way to reduce a risk of recurrence.  But can risk of recurrence be predicted?  Ouldamer and colleagues think so.  Essentially, they have developed a way of predicting the likelihood of recurrence.  Their findings are in line with previous studies exploring outcomes for ladies with BOT diagnosis – that completion surgery is the best treatment.

They reviewed the outcomes of 360 women in France with BOTs who received primary surgical treatment between January 2000 and December 2013. 

Their findings suggest that the risk of BOT recurrence can be accurately predicted so that women at high risk can benefit from adapted surgical treatment.

Their study suggests that recurrence is associated with 5 variables:

1. age < 45 years; 

2. preoperative serum tumour marker CA125 > 150 IU/mL; 

3. a serous histological subtype; 

4. International Federation of Gynecology and Obstetrics (FIGO) stage other than IA; and 

5. ovarian surgery other than bilateral salpingo-oophorectomy (BSO; i.e. cystectomy and unilateral salpingo-oophorectomy). 

Whilst data remains limited, this study suggests that

…….completion surgery should be offered, especially in women who have finished their families. Younger women appear to have lower risk of malignant transformation in conserved ovaries, although the risk of recurrent borderline tumours in conserved ovaries is high, especially after cystectomy.

Read more:

• Improving the clinical management of women with borderline tumours: a recurrence risk scoring system from a French multicentre study
• Borderline ovarian tumours: balancing risks of recurrence over decades