General Information
Tumors of low malignant potential (i.e., borderline tumors) account for 15% of all
epithelial ovarian cancers. Nearly 75% of these tumors are stage I at the time of
diagnosis. These tumors must be recognized because their prognosis and
treatment is clearly different from the frankly malignant invasive carcinomas.
A review of 22 series (953 patients) with a mean follow-up of 7 years revealed
a survival rate of 92% for patients with advanced-stage tumors, if patients with so-called
invasive implants were excluded. The cause of death was determined to be
benign complications of disease (e.g., small bowel obstruction), complications
of therapy, and only rarely (0.7%), malignant transformation.[1] In one
series, the 5-, 10-, 15-, and 20-year survival rates of patients with low
malignant potential tumors (all stages), as demonstrated by clinical life table
analysis, were 97%, 95%, 92%, and 89%, respectively.[2] In this series, mortality was stage
dependent: 0.7%, 4.2%, and 26.8% of patients with stages I, II, and III,
respectively, died of disease.[2] Another large study showed early stage, serous
histology, and younger age to be associated with a more favorable prognosis.[3]
In contrast to the excellent survival rates for early stage disease reported above, the Federation Internationale de Gynecologie et d’Obstetrique Annual Report (#21) included 529 patients with stage I tumors with a 5-year actuarial survival rate of 89.1%. Similarly, good survival was found in a
large prospective study.[4] Nonetheless, these survival rates are clearly in
contrast with the 30% survival rate for invasive tumors (all stages).
The less
common endometrioid tumor of low malignant potential should not be regarded as
malignant because it seldom, if ever, metastasizes. Malignant transformation
can, however, occur and may be associated with a similar tumor outside of the
ovary; such tumors are the result of either a second primary or rupture of the
primary endometrial tumor.[5]
References
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Kurman RJ, Trimble CL: The behavior of serous tumors of low malignant potential: are they ever malignant? Int J Gynecol Pathol 12 (2): 120-7, 1993.
[PUBMED Abstract]
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Leake JF, Currie JL, Rosenshein NB, et al.: Long-term follow-up of serous ovarian tumors of low malignant potential. Gynecol Oncol 47 (2): 150-8, 1992.
[PUBMED Abstract]
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Kaern J, Tropé CG, Abeler VM: A retrospective study of 370 borderline tumors of the ovary treated at the Norwegian Radium Hospital from 1970 to 1982. A review of clinicopathologic features and treatment modalities. Cancer 71 (5): 1810-20, 1993.
[PUBMED Abstract]
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Zanetta G, Rota S, Chiari S, et al.: Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol 19 (10): 2658-64, 2001.
[PUBMED Abstract]
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Norris HJ: Proliferative endometrioid tumors and endometrioid tumors of low malignant potential of the ovary. Int J Gynecol Pathol 12 (2): 134-40, 1993.
[PUBMED Abstract]
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