Aa
serous borderline ovarian cancer stage 3c
Hi, anybody with the same diagnosis as my daughter and can someone give me some encouragement with this diagnosis PLEASE ! x
MEDICAL PROFESSIONAL
Hi There
can you please give us more information such as:
what kind of surgery has she had
the exact wording of the pathology report?
Here is a nice link on information. Borderline ovarian tumors have a great prognosis
best wishes
http://emedicine.medscape.com/article/258970-overview
can you please give us more information such as:
what kind of surgery has she had
the exact wording of the pathology report?
Here is a nice link on information. Borderline ovarian tumors have a great prognosis
best wishes
http://emedicine.medscape.com/article/258970-overview
MEDICAL PROFESSIONAL
Hi There
thank you for the additional information.
Usually surgery alone is thought sufficient even with a stage 3. However the risk of recurrence is higher if there are invasive implants.
Chemotherapy in this setting is not uniformly done but I susect her doctors are giving it because of the invasive implants
She is clearly getting very good, aggressive therapy.Most women do not have a recurrence. There is a subset of women with advanced borderline tumors who do have recurrence.
I have pasted some articles on this topic.
Please keep in touch
take care
Ann Oncol. 2010 Aug 16. [Epub ahead of print]
How to follow up advanced-stage borderline tumours? Mode of diagnosis of recurrence in a large series stage II-III serous borderline tumours of the ovary.
Uzan C, Kane A, Rey A, Gouy S, Pautier P, Lhomme C, Duvillard P, Morice P.
Department of Gynecologic Surgery.
Abstract
BACKGROUND: The aim of this study was to describe how recurrences were diagnosed in the largest series of patients treated for an advanced-stage serous borderline ovarian tumour.
PATIENTS AND METHODS: From 1973 to 2006, 45 patients with a serous borderline tumour and peritoneal implants relapsed among 162 patients with a follow-up exceeding 1 year. Data concerning recurrences and the mode of diagnosis were reviewed.
RESULTS: The median follow-up interval was 8.2 years (range 19-286 months). The mode of diagnosis of recurrences was imaging (n = 19), clinical symptoms (n = 8), cancer antigen (CA) 125 elevation (n = 7), secondary surgery (n = 5) and unknown (n = 6). The median time to recurrence was 31 months (range 4-242 month). The type of recurrence was invasive low-grade serous carcinoma in 14 patients. Five patients died of recurrent tumour. Among the 39 patients with a known mode of diagnosis of recurrence, the most frequent diagnostic method for invasive recurrences was blood CA 125 elevation (6 of 13) and the majority of noninvasive recurrences were diagnosed by imaging (16 of 23).
CONCLUSIONS: This study demonstrates that ultrasound is the most relevant follow-up procedure in this context. Nevertheless, the blood CA 125 test is of particular interest for detecting invasive recurrent disease, which is the most crucial event.
Am J Surg Pathol. 2006 Nov;30(11):1367-71.
The recurrence and the overall survival rates of ovarian serous borderline neoplasms with noninvasive implants is time dependent.
Silva EG, Gershenson DM, Malpica A, Deavers M.
Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA. ***@****
Abstract
Ovarian serous borderline neoplasm with noninvasive implants traditionally have been considered to be nonaggressive tumors associated with an excellent prognosis. However, in our experience, recurrences commonly develop as patients are followed over many years. Eighty cases of advanced-stage ovarian serous borderline tumor with noninvasive implants were identified; the minimum follow-up period for these cases was 5 years or until the death of the patient. The following cases were excluded: patients treated by cystectomy, patients who died of other causes, patients who developed other tumors, and patients who had as the only positive material after resection of the primary borderline neoplasm a tumor detected on a second look or third look operation. Hematoxylin and eosin-stained slides from the original ovarian tumor and the staging biopsies were reviewed in all cases. Slides of the recurrent tumor were available in all cases except for 2 in which the diagnosis was established clinically. The presence or absence of a micropapillary/cribriform pattern and microinvasion in the ovarian tumor was recorded. Follow-up was obtained from the patients' charts. Fischer exact test was used for statistical analysis. The patients' ages ranged from 17 to 67 years (median 36 y). Seventy-three patients were treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy. Seven patients were treated by total abdominal hysterectomy and unilateral salpingo-oophorectomy. The International Federation of Gynecology and Obstetrics stage was as follows: stage II (29 cases), stage III (50 cases), and stage IV (1 case). After surgery, 58 patients were treated with chemotherapy, 7 with radiotherapy, and 1 with hormonal therapy. The follow-up ranged from 5 to 31 years (median 15.7 y). Thirty-five patients (44%) developed recurrences. Only 10% of the patients had a recurrence in less than 5 years, 19% had their recurrences between 5 and 10 years, 10% between 10 and 15 years, and 5% more than 15 years after resection of the primary neoplasm. The only statistically significant feature associated with recurrence was the presence of a micropapillary/cribriform pattern, although this pattern was present in only 26% of the cases that recurred. Of the 35 patients who had a recurrence, 2 were diagnosed clinically, both are alive with progressive disease at 1 and 5 years after the diagnosis of the recurrence; 6 had recurrent serous borderline tumors, all are without evidence of disease with a follow-up ranging from 7 to 18 years after resection of the ovarian borderline tumor (median 14 y); and 27 patients subsequently developed low-grade serous carcinoma, 7 are alive with progressive disease with a follow-up ranging from 10 to 29 years (median 15 y) and 20 died of disease between 3 to 25 years after resection of the ovarian borderline tumor (median 16 y). In summary, the true recurrence rate of ovarian serous borderline tumors with noninvasive implants can only be obtained through a long follow-up. In this group of patients, 77% and 34% of the subsequent tumors developed 5 years and 10 years after diagnosis of the ovarian tumor, respectively. Histologic examination of the recurrent tumor is important in determining further therapy and prognosis for these patients; all patients who recurred with borderline tumor are without evidence of disease, whereas 74% of the patients who recurred with low-grade serous carcinoma died of disease. We propose that patients be followed for a minimum of 10 years to evaluate for recurrences and for 20 years to evaluate for survival
thank you for the additional information.
Usually surgery alone is thought sufficient even with a stage 3. However the risk of recurrence is higher if there are invasive implants.
Chemotherapy in this setting is not uniformly done but I susect her doctors are giving it because of the invasive implants
She is clearly getting very good, aggressive therapy.Most women do not have a recurrence. There is a subset of women with advanced borderline tumors who do have recurrence.
I have pasted some articles on this topic.
Please keep in touch
take care
Ann Oncol. 2010 Aug 16. [Epub ahead of print]
How to follow up advanced-stage borderline tumours? Mode of diagnosis of recurrence in a large series stage II-III serous borderline tumours of the ovary.
Uzan C, Kane A, Rey A, Gouy S, Pautier P, Lhomme C, Duvillard P, Morice P.
Department of Gynecologic Surgery.
Abstract
BACKGROUND: The aim of this study was to describe how recurrences were diagnosed in the largest series of patients treated for an advanced-stage serous borderline ovarian tumour.
PATIENTS AND METHODS: From 1973 to 2006, 45 patients with a serous borderline tumour and peritoneal implants relapsed among 162 patients with a follow-up exceeding 1 year. Data concerning recurrences and the mode of diagnosis were reviewed.
RESULTS: The median follow-up interval was 8.2 years (range 19-286 months). The mode of diagnosis of recurrences was imaging (n = 19), clinical symptoms (n = 8), cancer antigen (CA) 125 elevation (n = 7), secondary surgery (n = 5) and unknown (n = 6). The median time to recurrence was 31 months (range 4-242 month). The type of recurrence was invasive low-grade serous carcinoma in 14 patients. Five patients died of recurrent tumour. Among the 39 patients with a known mode of diagnosis of recurrence, the most frequent diagnostic method for invasive recurrences was blood CA 125 elevation (6 of 13) and the majority of noninvasive recurrences were diagnosed by imaging (16 of 23).
CONCLUSIONS: This study demonstrates that ultrasound is the most relevant follow-up procedure in this context. Nevertheless, the blood CA 125 test is of particular interest for detecting invasive recurrent disease, which is the most crucial event.
Am J Surg Pathol. 2006 Nov;30(11):1367-71.
The recurrence and the overall survival rates of ovarian serous borderline neoplasms with noninvasive implants is time dependent.
Silva EG, Gershenson DM, Malpica A, Deavers M.
Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA. ***@****
Abstract
Ovarian serous borderline neoplasm with noninvasive implants traditionally have been considered to be nonaggressive tumors associated with an excellent prognosis. However, in our experience, recurrences commonly develop as patients are followed over many years. Eighty cases of advanced-stage ovarian serous borderline tumor with noninvasive implants were identified; the minimum follow-up period for these cases was 5 years or until the death of the patient. The following cases were excluded: patients treated by cystectomy, patients who died of other causes, patients who developed other tumors, and patients who had as the only positive material after resection of the primary borderline neoplasm a tumor detected on a second look or third look operation. Hematoxylin and eosin-stained slides from the original ovarian tumor and the staging biopsies were reviewed in all cases. Slides of the recurrent tumor were available in all cases except for 2 in which the diagnosis was established clinically. The presence or absence of a micropapillary/cribriform pattern and microinvasion in the ovarian tumor was recorded. Follow-up was obtained from the patients' charts. Fischer exact test was used for statistical analysis. The patients' ages ranged from 17 to 67 years (median 36 y). Seventy-three patients were treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy. Seven patients were treated by total abdominal hysterectomy and unilateral salpingo-oophorectomy. The International Federation of Gynecology and Obstetrics stage was as follows: stage II (29 cases), stage III (50 cases), and stage IV (1 case). After surgery, 58 patients were treated with chemotherapy, 7 with radiotherapy, and 1 with hormonal therapy. The follow-up ranged from 5 to 31 years (median 15.7 y). Thirty-five patients (44%) developed recurrences. Only 10% of the patients had a recurrence in less than 5 years, 19% had their recurrences between 5 and 10 years, 10% between 10 and 15 years, and 5% more than 15 years after resection of the primary neoplasm. The only statistically significant feature associated with recurrence was the presence of a micropapillary/cribriform pattern, although this pattern was present in only 26% of the cases that recurred. Of the 35 patients who had a recurrence, 2 were diagnosed clinically, both are alive with progressive disease at 1 and 5 years after the diagnosis of the recurrence; 6 had recurrent serous borderline tumors, all are without evidence of disease with a follow-up ranging from 7 to 18 years after resection of the ovarian borderline tumor (median 14 y); and 27 patients subsequently developed low-grade serous carcinoma, 7 are alive with progressive disease with a follow-up ranging from 10 to 29 years (median 15 y) and 20 died of disease between 3 to 25 years after resection of the ovarian borderline tumor (median 16 y). In summary, the true recurrence rate of ovarian serous borderline tumors with noninvasive implants can only be obtained through a long follow-up. In this group of patients, 77% and 34% of the subsequent tumors developed 5 years and 10 years after diagnosis of the ovarian tumor, respectively. Histologic examination of the recurrent tumor is important in determining further therapy and prognosis for these patients; all patients who recurred with borderline tumor are without evidence of disease, whereas 74% of the patients who recurred with low-grade serous carcinoma died of disease. We propose that patients be followed for a minimum of 10 years to evaluate for recurrences and for 20 years to evaluate for survival
she has invasive implants. she has been operated on at barts hospital in london by a gynaecologist oncologist, full hysterectomy and debulking. scans now clear. it had spread to both ovaries, right fallopean tube, omentun, pouch of douglas which is unusual for borderline which is why they staged it a 3c. she is undergoing chemo, taxol/carboplatin which they have said might not work in clearing up any remaining cells.
i am worried sick. tumours found in both ovaries were borderline.
i am worried sick. tumours found in both ovaries were borderline.
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