Serous papillary

[Kiki774]

I’m 34 and had my right oophorectomy 2 months ago and the histology revealed that it was well differentiated papillary serous cystadenocarcinoma ( FIGO stage 1A ) on my ovarian cyst.. The CA 125 was 46.4.
I got a second opinion to have another histology revealed and the second report of  diagnosis for right ovarian cyst ( received two (H&E) stained slides review from the lab) :- serous papillary cystadenoma of borderline malignancy.
Please advice on this case do I need any chemotherapy or what should I need to do about it?
Regards
Confused girl

[msjazz]

I am stage 3c, I found this from 07 cancer meeting. Even with the low chance or recurrence, I personally might do chemo to be sure no cells were missed. Donna


  Home > Abstracts & Virtual Meeting > Abstracts > 2007 ASCO Annual Meeting

Recurrence in ovarian carcinoma stage I A/B grade 1 and 2 with and without chemotherapy.
Sub-category:  Ovarian Cancer  
Category:  Gynecologic Cancer  
Meeting:  2007 ASCO Annual Meeting  
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Abstract No: 5565
Citation: Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007: 5565
Author(s): f. simpkins, F. Abu Shahim, J. N. Bakkum-Gamez, M. B. Jones, R. P. Rocconi, K. S. Mathews, K. N. Moore, D. N. Fong, P. G. Rose
Abstract: Background: The goal of this study was to determine the recurrence rates (R) of patients with grade 1 and 2 stage 1A and IB ovarian tumors treated with and without chemotherapy. Methods: We conducted a five-center retrospective study of patients with Stage 1A/B grade 1 and 2 ovarian carcinoma. All women underwent comprehensive staging including a minimum of unilateral salpingo-ophorectomy, unilateral pelvic and para-aortic lymphadenectomy, and omentectomy. Clear cell histologies were classified as grade 3 and excluded. The minimum cancer-free survivor follow-up was 3 years. Results: We identified 82 patients with Stage 1A/B grade 1 and 2 who met criteria for the study. The median age was 58 yrs (range 29 to 83) and the median follow-up was 5.3 yrs (range 3 to 11 yrs). The majority were of endometrioid histology (51), followed by mucinous (19), papillary serous (11), and mixed (1). Recurrences were of endometrioid (4), mucinous (1), or papillary serous (1) histology. For Stage 1A, overall recurrence rate was 9% (6/67). The overall recurrence rates for Stage 1A, grade1 tumors was 6% and among grade 2 tumors 12% (p=0.40). Among Stage 1A patients not treated with chemotherapy, there was a 7% (2/29) and 9.5% (2/21) recurrence rate for grade 1 and grade 2 tumors, respectively. For the grade 1 tumors, both patients are alive with disease at 3 and 5 yrs. For the grade 2 tumors, one is alive without evidence of disease at 7 yrs and the other died from disease at 4 yrs. Time to recurrence (TTR) was 2.3 yrs for grade 1 tumors and 2.6 yrs for grade 2 tumors. For Stage 1A patients treated with a platinum chemotherapy regimen, there were no recurrences (0/5) for grade 1 tumors and a 16% (2/12) recurrence rate for grade 2 tumors. Of the recurrences, one patient died from disease at 1.4 yrs and the other is alive with stable disease at 6 yrs. Time to recurrence was 2.85 yrs for grade 2 tumors. For grade 1 or 2, Stage 1A tumors, recurrence rates and time to recurrence were not effected by chemotherapy administration (R, p=0.55 and p=0.54, respectively; TTR, grade 2, p=0.85). No recurrences were observed in the 15 patients with Stage IB, grade 1 and 2 tumors. Conclusions: In comprehensively staged patients with Stage 1A/B, grade 1 and 2, low recurrence rates suggest adjuvant chemotherapy may not be indicated.

Abstract Disclosures  

[chelan3]

Hi Kiki, it was wise to have a second opinion done on the pathology.  Since your diagnosis is Stage 1a Borderline it usually is treated with surgery only.   Now for borderline ovca they recommend being conservative in the surgery department especially if you're young.  I was 32 when my left adnexal complex cyst was diagnosised as Stage 1a serous pappilary Low Malignant Potential ovarian cancer which is also called Borderline Ovarian cancer. I received surgery only and also opted for a complete hysterectomy a year later on the advise of my dr.  Your specific type is a little different than mine so you may want to check with Dr Goodman on the Ask the Dr board.  For mine they only took the left ovary and tube (cyst had grown into the tube) at first and then recommended a hysterectomy.  As I mentioned before they don't often recommend hysterecomy anymore - especially for women not in menapause already.  I'm not sure if you're able to see a gyn-oncologist, but if you are you should see one.  Or, if you can find one a specialist in Borderline cancers would be good too.  Because the 2nd pathology was different from the first pathology you may want to even have a third one done to see if confirms the borderline diagnosis.  If it's not borderline stage 1a, but 'regular' ovca stage 1a some dr's recommend chemo so it's a good idea to be really sure of the diagnosis.  
Good luck to you and let us know how you make out.
Debbie

[Kiki774]

How to post a question to Dr. Goodman...cos i can't find it?

Rgds
Kiki

[chelan3]

On the right hand side of this screen it says Related Expert Forums - click on Ovarian Cancer.