Borderline ovarian tumors in Denmark 1997-2018: Time trends in incidence by histology, age and educational level

Predicting Malignancy in Adnexal Tumors With FAPI PET/CT and FDG PET/CT: A Case Report on a Borderline Ovarian Tumor

ABSTRACT

A 54-year-old woman presented with a 55 × 64-mm tumor in the ovary with high [ 18 F]FDG uptake on [ 18 F]FDG PET/CT highly suggestive of ovarian cancer. Prior to surgery, the patient underwent [ 68 Ga]-Ga- fibroblast activation protein inhibitor (FAPI)-46 PET/CT, which revealed low [ 68 Ga]-Ga-FAPI-46 tumor uptake. Histopathology revealed a borderline ovarian tumor, which has low malignant potential and a 10-year survival rate greater than 93%. High [ 18 F]FDG uptake is considered a fair predictor of malignancy in adnexal tumors. The present case demonstrates the potential superiority of [ 68 Ga]-Ga-FAPI-46 PET/CT over [ 18 F]-FDG PET/CT in differentiating malignant adnexal tumors from borderline ovarian tumors.

Risk of borderline ovarian tumors after fertility treatment - Results from a Danish cohort of infertile women

OBJECTIVE

Results from previous studies examining the association between fertility treatment and borderline ovarian tumors are inconsistent. The aim of this study was to investigate the association between fertility treatment and borderline ovarian tumors in a cohort of infertile women.

METHODS

This cohort study was based on the Danish Infertility Cohort and included all infertile women aged 20-45 years living in Denmark between 1 January 1995 and 31 December 2017 (n = 146,891). Information on use of fertility drugs, borderline ovarian tumors and cancer diagnoses, covariates, emigration, and vital status was obtained by linkage to national registers. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) with adjustment for potential confounders for overall borderline ovarian tumors and for serous- and mucinous borderline ovarian tumors separately.

RESULTS

During a median 11.3 years of follow-up, 144 women developed a borderline ovarian tumor. No marked associations between ever use of clomiphene citrate, gonadotropins, gonadotropin-releasing hormone receptor modulators, human chorionic gonadotropin or progesterone and borderline ovarian tumors were observed, neither overall nor for serous and mucinous borderline ovarian tumors analysed separately. Further, no clear associations with borderline ovarian tumors were found according to cumulative dose, time since first use or parity status for any fertility drugs.

CONCLUSIONS

No marked associations between use of fertility drugs and borderline ovarian tumors were observed. However, the cohort's relatively young age at end of follow-up emphasizes the importance of extending the follow-up period for women who have used fertility drugs.

Risk of nonovarian cancer in a nationwide-based study of nearly 5000 women with borderline ovarian tumors in Denmark

Evidence regarding cancer risk after borderline ovarian tumors (BOTs) is limited. We conducted a nationwide cohort study examining the incidence of nonovarian cancers in women with serous or mucinous BOTs compared with the general female population with up to 41 years of follow-up. Through the nationwide Pathology Registry, we identified nearly 5000 women with BOTs (2506 serous and 2493 mucinous) in Denmark, 1978 to 2018. We computed standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) as relative risk estimates of specific nonovarian cancers. Compared with general female population rates, women with serous BOTs had increased rates of particularly malignant melanoma (SIR = 1.9; 95% CI: 1.3-2.6), thyroid cancer (SIR = 3.0; 95% CI: 1.4-5.4) and myeloid leukemia (SIR = 3.2; 95% CI: 1.5-5.8), and women with mucinous BOTs had elevated rates of lung cancer (SIR = 1.7; 95% CI: 1.3-2.1), pancreatic cancer (SIR = 1.9; 95% CI: 1.2-2.9) and myeloid leukemia (SIR = 2.3; 95% CI: 0.9-4.7). We found no convincing association with neither breast nor colorectal cancer in women with BOTs. This is the first large nationwide study showing that women with specific types of BOTs have increased risks of several nonovarian cancers, likely due to some shared risk factors or genetic characteristics.

Evaluation of Clinicopathologic Factors and Surgery Management on Borderline Ovarian Tumor Outcomes

Background: Borderline ovarian tumor (BOT) is a tumor most prevalent in young woman with desire to fertility. There are some controversies on the patient characteristic besides to the factors affecting the recurrence rate among different races. Objectives: The aim of this study is to evaluate clinicopathologic features of the tumor to discover the controversies on the topic. Methods: Medical data of the all referred patients to Motahari clinic from January 2010 till October 2020 were recorded. Patient clinicopathologic characteristics affecting on outcome were evaluated. By using SPSS software, data were tested by chi-square and fish exact test. Also, log rank test was used for survival analysis Results: Totally 145 patients were enrolled. 61.4% versus 38.6% of the patients underwent fertility sparing surgery and radical surgery respectively with common characteristics of mostly belong to stage 1A disease (61.8% vs. 66.1%), unilateral (93.3% vs. 89.3%), serous histology (51.7% vs. 66.1%). The characteristics were different in the aspects of age and tumor size. In the aspect of recurrence rate, higher FIGO stage, younger age, tumor size less than 10cm, performing laparoscopy and fertility sparing surgery were with higher rate of recurrence (P-value < 0.05) while histology type of the tumor, lateralization, micropapillary, microinvasion, noninvasive peritoneal implants, receiving adjuvant chemotherapy and performing lymphadenectomy were not statistically significant for recurrence (P-value > 0.05). Two patients had malignant transformation. Conclusions: Fertility sparing surgery was with more recurrence rate in borderline ovarian tumor patients. However, micropapillary, microinvasion were not significantly with higher recurrence rate in our study but they are challenging issues in border line ovarian tumors among different studies. Due to most prevalence of border line ovarian tumors in young women and desire of fertility preservation, we should notice more to clinicopathologic and surgery types affecting on recurrence of BOTs.

Nationwide population-based study of prevalence and trend of borderline ovarian tumors in the Republic of Korea

Borderline ovarian tumors (BOTs) represent noninvasive tumors with uncertain malignant potential. They have a favorable prognosis although they can also recur or be fatal. There are limited population-based data on BOTs, its incidence and surgical treatment approach. We sought to analyze these trends in South Korea between 2014 and 2018. Data from patients diagnosed with BOT between 2014 and 2018 were obtained from the Health Insurance Review and Assessment Service/National Inpatient Sample in South Korea. Treatment was analyzed by using codes including adnexal surgery with or without hysterectomy. Data from 4,636,542 women were entered into the database between 2014 and 2018. Data from 5,109 women with BOT, and 537 women with surgery were extracted for analysis. The highest prevalence of BOT occurred in women 40–44 years old. In logistic regression analysis, age was significantly correlated with the prevalence of BOT (p < 0.05). The prevalence of BOT was lower in individuals over 50 than it was in those under 50 years (odds ratio (OR), 0.400 in 2014; OR, 0.457 in 2015; OR, 0.419 in 2016; OR, 0.355 in 2017; OR, 0.347 in 2018). The prevalence of BOT varies significantly with age, and is most common in women in their 40 s.