paywalled: Management and Prognosis of Clear Cell Borderline Ovarian Tumor.

Management and Prognosis of Clear Cell Borderline Ovarian Tumor.:

Abstract
BACKGROUND: The clear cell borderline ovarian tumor (CCBOT) of the ovary is a rare tumor accounting for less than 1% of BOT. Fewer than 25 cases have been reported in the literature (including details on clinical management and outcomes). The aim of this study was to determine the prognosis of a series of CCBOTs collected in 2 reference centers.
PATIENTS AND METHODS: This was a retrospective review of patients with CCBOT treated or referred to our institutions. A centralized histological review by a reference pathologist and data on the clinical characteristics, management, and outcomes of patients were required for inclusion.
RESULTS: Twelve patients were identified between 2000 and 2010. The median age of patients was 68 years (range, 36-83 years). Two had been treated conservatively and 9 radically (data unknown in 1). The tumor was unilateral in 11 cases. All patients had stage I disease. All cases were CCBOT with an adenofibromatous pattern. Stromal microinvasion or intraepithelial carcinoma was histologically associated in 2 and 3 cases, respectively. Four of the 12 patients had synchronous endometrial disorders (but no endometrioid carcinoma). No cases were histologically associated with endometriosis. Four patients were lost to follow-up. Among 8 other patients, after a median period of 28 months (range, 2-129 months), no recurrence had occurred (1 patient had died of another disease).
CONCLUSION: Clear cell borderline ovarian tumor carries a good prognosis. All tumors are (blogger's note - 'were' in this study of 12 pts) stage I; therefore, surgical staging is not necessary in most of the cases. Conservative treatment could be proposed to young patients, but uterine curettage would then be required in cases of uterine preservation.

Pathol. 2012 - abstract (Japan) "Piling up" clear cells in müllerian-type mucinous and mixed cell-type borderline tumor do not represent concomitant clear cell neoplasms (mucinous/mixed/clear cell/borderline/ER....)

Hum Pathol. 2012 Mar 19. [Epub ahead of print]

"Piling up" clear cells in müllerian-type mucinous and mixed cell-type borderline tumor do not represent concomitant clear cell neoplasms.

Abstract

The nature of "piling up" proliferation of clear cells in müllerian mucinous/mixed borderline tumor has not been well characterized. The purpose of this study was to clarify whether or not such clear cells represent concomitant clear cell neoplasms.

First, we carefully reviewed hematoxylin and eosin slides taken from 139 ovarian tumors diagnosed as clear cell carcinoma (112 cases) and müllerian mucinous/mixed borderline tumor (27 cases) to clarify (1) the frequency of piling-up clear cells in müllerian mucinous/mixed borderline tumor and (2) the frequency of the coexistence of typical clear cell carcinoma and müllerian mucinous/mixed borderline tumor.

Second, we investigated the immunohistochemical expression of estrogen receptor, hepatocyte nuclear factor-1β, and glypican-3 in proliferating clear cells in both tumors.

We identified piling-up clear cells in 56% of müllerian mucinous/mixed borderline tumors. Such clear cells lacked the severe nuclear atypia, complex branching, and dense hyalinized cores of typical clear cell carcinoma. We did not find coexistence of typical clear cell carcinoma and müllerian mucinous/mixed borderline tumor in any tumors.

Piling-up clear cells and endocervical-like mucinous cells were positive for estrogen receptor but negative for hepatocyte nuclear factor-1β and glypican-3. Most clear cell carcinomas showed a hepatocyte nuclear factor-1β-positive/estrogen receptor-negative immunophenotype, and about half of them were glypican-3 positive.

In conclusion, piling-up clear cells in müllerian mucinous/mixed borderline tumor do not represent concomitant clear cell neoplasms because clear cell carcinoma and müllerian mucinous/mixed borderline tumor hardly ever coexist and because such clear cells in both tumors are immunophenotypically distinct.

abstract: Management and prognosis of endometrioid borderline tumors of the ovary

Management and prognosis of endometrioid borderline tumors of the ovary
Source: Surgical Oncology

Background 
The Endometrioid Borderline ovarian tumor (EBOT) is the third most common histological subtype of borderline ovarian tumors. Very little is known about the prognosis and management of this entity. This paper consists of a review of the literature and an analysis of clinical series.

Study design 
A review of the literature on this topic was conducted identifying series reporting consecutive cases of EBOT using 2 search engines (MEDLINE and Pubmed). Personal data on this topic have been included and concern a series of patients treated between 1985 and 2009 for EBOT. These cases included in this series had complete data concerning patient management and follow-up >12 months.

Results 
16 patients were studied: 7 had been treated conservatively and 9 radically. All 16/16 patients had stage I disease at the initial diagnosis but one patient had also developed synchronous endometrioid adenocarcinoma of the uterine corpus. After a median time of 24 months (range, 12–132) post treatment, one (1/16) patient had developed two recurrences. She remains disease-free 42 months after the end of treatment of the last recurrence. These data were compared to the results of 4 series previously reported in the literature. In fact, the present series reports on the first recurrence in EBOT (which was an invasive lesion).

Conclusion 
Endometrioid borderline ovarian tumors carry a good prognosis. Most EBOT tumors are stage I, therefore surgical staging is not necessary in most of the cases. However, uterine curettage is required in cases of uterine preservation.

abstract: Accuracy of Frozen-Section Diagnosis of Ovarian Mucinous Tumors

Conclusions:
The sensitivity of frozen-section diagnosis of LMP and malignant mucinous tumors was low. The inaccuracy of a frozen-section diagnosis of ovarian mucinous tumors may be related to a tumor size of greater than 13 cm. Increasing the number of intraoperative samples over 3 sections per case may not effectively increase the accuracy of frozen-section diagnosis in mucinous tumors.

abstract: Mucinous tumor of low malignant potential ("borderline" or "atypical proliferative" tumor) of the ovary: a study of 171 cases with the asses

Abstract

Mucinous tumors of the ovary are a continuing source of controversy in the field of gynecologic pathology. We examined a series of 171 intestinal-type mucinous tumors of low malignant potential ("borderline" or "atypical proliferative" tumors) to clarify the clinical significance of intraepithelial carcinoma (IECA) and microinvasion (area ≤ 10 mm²). The diagnosis of IECA was based on the presence of marked nuclear atypia (grade 3). Stromal microinvasion was classified as low grade and high grade (with nuclear grade 3). IECA was observed in 67 of 171 cases (39.2%). Microinvasion was identified in 31 (18.1%) cases, low grade in 22 (12.9%) cases, and high grade in 9 (5.3%) cases. Follow-up status was known in 144 cases and tumor recurrence was observed in 6 patients (4.2%). The risk factors for recurrence included International Federation of Gynecology and Obstetrics stage ≥ IC (P=0.002), microinvasion (P=0.013), age less than 45 years (P=0.032), and IECA (P=0.042). The amount of IECA ≥ 10% was also associated with the risk of recurrence (P=0.007). Among tumors with microinvasion, there was no significant association between the clinicopathologic variables and recurrence. When considering tumors with stage ≥ IC, tumor recurrence was significantly associated with IECA ≥ 10% (P=0.031) and age less than 45 years (P=0.047). It is important that mucinous tumors of low malignant potential should be staged and be optimally sampled for pathologic examination to document the status of the external surface or peritoneal involvement and to identify the worst degree of epithelial proliferation. Tumor stage ≥ IC, IECA ≥ 10%, microinvasion, and age less than 45 years were the features that were associated with tumor recurrence.
The study results also support the use of nuclear grade 3 as the sole criterion of IECA.

Search Results - 'lmp ovarian' 'borderline ovarian' 2011 ASCO abstract

Find EXACT phrase: lmp ovarian

Found 1 document.

A multivariate longitudinal algorithm for early detection of ovarian cancer using multiple biomarker

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Find EXACT phrase: borderline ovarian
Found 2 documents, showing 1 - 2

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1. Regulation of the tumor suppressor gene PAEP in the transition from serous borderline ovarian tumors to low-grade serous ovarian carcinomas. | 2011 ASCO Annual Meeting Abstracts
   ... from serous borderline ovarian tumors to low-grade serous ovarian carcinomas. | 2011 ASCO ...
   ... Background: Serous borderline ovarian tumors (SBOT) and low grade serous ovarian carcinomas (LG) ...
   
2. Elevation of HE4 and CA 125 in symptomatic patients with invasive epithelial ovarian cancer. | 2011 ASCO Annual Meeting Abstracts
   ... were malignant. Borderline ovarian tumors were excluded from the analyses. A total of 115 cases ...

Nuclear P27 (gene) expression in benign, borderline (LMP) and invasive tumors of the ovary and its association with prognosis: A GOG group study

Abstract

Objective

Nuclear p27 expression was examined in non-invasive and invasive ovarian tumors from a cross-sectional study, and clinical relevance of p27 was evaluated in the primary tumors from women participating in two randomized phase III treatment trials.

Methods

An immunohistochemistry assay was used to detect p27 in formalin-fixed paraffin-embedded ovarian tumors from 3 distinct sources.

Research Highlights

► Low p27 expression is associated with malignant transformation of the ovary.
► A cyclin E to p27 ratio > 1.0 may be associated with shorter survival.
► Study required confirming increased recurrences with low p27 in early stage patients.

Serous and mucinous borderline ovarian tumors (LMP): are there real differences between these two entities?

Objective
To evaluate the clinical outcome and pathological features of patients with borderline ovarian tumors (BOT) with special emphasis on serous and mucinous histology.


Conclusions
Serous tumors present more unfavorable anatomopathological characteristics but are associated with better prognosis than mucinous tumors. If mucinous BOT diagnosis is retained physicians should be aware that their aggressive potential is not negligible.

full free access: Genomic aberrations in borderline ovarian tumors

Note: this paper is long and technical but of importance given, in part, the connection to Lynch Syndrome (MSI testing, microsatellite). Microsatellite testing is a test commonly used for suspected Lynch Syndrome patients. Specific research regarding ovarian cancer (epithelial) /MSI is limited.

Background
"According to the scientific literature, less than 30 borderline ovarian tumors have been karyotyped and less than 100 analyzed for genomic imbalances by CGH."

Ovarian Low Malignant Potential Tumors (borderline ovarian tumors) Treatment, Masonic Cancer Center, University of Minnesota

Note: also commonly referred to as "LMP"

The pathology of and controversial aspects of ovarian borderline tumours

Abstract
PURPOSE OF REVIEW: Ovarian borderline tumours are relatively uncommon, but not rare, neoplasms. Pathologists and oncologists often struggle with various aspects of borderline tumours which are sometimes controversial and poorly understood.

Low malignant potential tumors with micropapillary features are molecularly similar to low-grade serous carcinoma of the ovary.

CONCLUSION: The gene expression profile of LMP-MP is similar to LGSC and distinct from LMP, reflecting their more aggressive clinical behavior. *Low-grade serous carcinoma (LGSC) *LMP with micropapillary features (LMP-MP)

econdary Surgery in Patients With Serous Low Malignant Potential Ovarian Tumors With Peritoneal Implants

Conclusions: Secondary surgery seems to reduce the risk of recurrence in patients with serous LMPOT and peritoneal implants. Patients with residual disease are probably those likely to benefit from such surgery. Further studies are needed to confirm these preliminary results.

Phase II trial of the histone deacetylase inhibitor belinostat in women with platinum resistant epithelial ovarian cancer and micropapillary (LMP) ovarian tumours

Phase II trial of the histone deacetylase inhibitor belinostat in women with platinum resistant epithelial ovarian cancer and micropapillary (LMP) ovarian tumours.

CONCLUSIONS: Belinostat is well tolerated in both patient groups and shows some activity in patients with micropapillary (LMP) disease.