Surgical staging and prognosis in serous borderline ovarian tumours (BOT): A subanalysis of the AGO ROBOT study

F. Trillsch; S. Mahner; E. Vettorazzi; L. Woelber; A. Reuss; K. Baumann; M. D. Keyver-Paik; U. Canzler; K. Wollschlaeger; D. Forner; J. Pfisterer; W. Schroeder; K. Muenstedt; B. Richter; C. Fotopoulou; B. Schmalfeldt; A. Burges; N. Ewald-Riegler; N. De Gregorio; F. Hilpert; T. Fehm; W. Meier; P. Hillemanns; L. Hanker; A. Hasenburg; H. G. Strauss; M. Hellriegel; P. Wimberger; S. Kommoss; F. Kommoss; S. Hauptmann; A. du Bois

doi:10.1038/bjc.2014.648

Surgical staging and prognosis in serous borderline ovarian tumours (BOT): A subanalysis of the AGO ROBOT study

F. Trillsch, S. Mahner^*, E. Vettorazzi, L. Woelber, A. Reuss, K. Baumann, M. D. Keyver-Paik, U. Canzler, K. Wollschlaeger, D. Forner, J. Pfisterer, W. Schroeder, K. Muenstedt, B. Richter, C. Fotopoulou, B. Schmalfeldt, A. Burges, N. Ewald-Riegler, N. De Gregorio, F. HilpertT. Fehm, W. Meier, P. Hillemanns, L. Hanker, A. Hasenburg, H. G. Strauss, M. Hellriegel, P. Wimberger, S. Kommoss, F. Kommoss, S. Hauptmann, A. du Bois

^*Corresponding author for this work

Clinic of Gynecology and Obstetrics

19 Citations (Scopus)

Abstract

Background:Incomplete surgical staging is a negative prognostic factor for patients with borderline ovarian tumours (BOT). However, little is known about the prognostic impact of each individual staging procedure.Methods:Clinical parameters of 950 patients with BOT (confirmed by central reference pathology) treated between 1998 and 2008 at 24 German AGO centres were analysed. In 559 patients with serous BOT and adequate ovarian surgery, further recommended staging procedures (omentectomy, peritoneal biopsies, cytology) were evaluated applying Cox regression models with respect to progression-free survival (PFS).Results:For patients with one missing staging procedure, the hazard ratio (HR) for recurrence was 1.25 (95%-CI 0.66-2.39; P=0.497). This risk increased with each additional procedure skipped reaching statistical significance in case of two (HR 1.95; 95%-CI 1.06-3.58; P=0.031) and three missing steps (HR 2.37; 95%-CI 1.22-4.64; P=0.011). The most crucial procedure was omentectomy which retained a statistically significant impact on PFS in multiple analysis (HR 1.91; 95%-CI 1.15-3.19; P=0.013) adjusting for previously established prognostic factors as FIGO stage, tumour residuals, and fertility preservation.Conclusion:Individual surgical staging procedures contribute to the prognosis for patients with serous BOT. In this analysis, recurrence risk increased with each skipped surgical step. This should be considered when re-staging procedures following incomplete primary surgery are discussed.

Original language	English
Journal	British Journal of Cancer
Volume	112
Issue number	4
Pages (from-to)	660-666
Number of pages	7
ISSN	0007-0920
DOIs	https://doi.org/10.1038/bjc.2014.648
Publication status	Published - 17.02.2015

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Trillsch, F., Mahner, S., Vettorazzi, E., Woelber, L., Reuss, A., Baumann, K., Keyver-Paik, M. D., Canzler, U., Wollschlaeger, K., Forner, D., Pfisterer, J., Schroeder, W., Muenstedt, K., Richter, B., Fotopoulou, C., Schmalfeldt, B., Burges, A., Ewald-Riegler, N., De Gregorio, N., ... du Bois, A. (2015). Surgical staging and prognosis in serous borderline ovarian tumours (BOT): A subanalysis of the AGO ROBOT study. British Journal of Cancer, 112(4), 660-666. https://doi.org/10.1038/bjc.2014.648

@article{571930572abb4e5cb1714d72929d90ca,

title = "Surgical staging and prognosis in serous borderline ovarian tumours (BOT): A subanalysis of the AGO ROBOT study",

abstract = "Background:Incomplete surgical staging is a negative prognostic factor for patients with borderline ovarian tumours (BOT). However, little is known about the prognostic impact of each individual staging procedure.Methods:Clinical parameters of 950 patients with BOT (confirmed by central reference pathology) treated between 1998 and 2008 at 24 German AGO centres were analysed. In 559 patients with serous BOT and adequate ovarian surgery, further recommended staging procedures (omentectomy, peritoneal biopsies, cytology) were evaluated applying Cox regression models with respect to progression-free survival (PFS).Results:For patients with one missing staging procedure, the hazard ratio (HR) for recurrence was 1.25 (95%-CI 0.66-2.39; P=0.497). This risk increased with each additional procedure skipped reaching statistical significance in case of two (HR 1.95; 95%-CI 1.06-3.58; P=0.031) and three missing steps (HR 2.37; 95%-CI 1.22-4.64; P=0.011). The most crucial procedure was omentectomy which retained a statistically significant impact on PFS in multiple analysis (HR 1.91; 95%-CI 1.15-3.19; P=0.013) adjusting for previously established prognostic factors as FIGO stage, tumour residuals, and fertility preservation.Conclusion:Individual surgical staging procedures contribute to the prognosis for patients with serous BOT. In this analysis, recurrence risk increased with each skipped surgical step. This should be considered when re-staging procedures following incomplete primary surgery are discussed.",

author = "F. Trillsch and S. Mahner and E. Vettorazzi and L. Woelber and A. Reuss and K. Baumann and Keyver-Paik, {M. D.} and U. Canzler and K. Wollschlaeger and D. Forner and J. Pfisterer and W. Schroeder and K. Muenstedt and B. Richter and C. Fotopoulou and B. Schmalfeldt and A. Burges and N. Ewald-Riegler and {De Gregorio}, N. and F. Hilpert and T. Fehm and W. Meier and P. Hillemanns and L. Hanker and A. Hasenburg and Strauss, {H. G.} and M. Hellriegel and P. Wimberger and S. Kommoss and F. Kommoss and S. Hauptmann and {du Bois}, A.",

note = "Publisher Copyright: {\textcopyright} 2015 Cancer Research UK.",

year = "2015",

month = feb,

day = "17",

doi = "10.1038/bjc.2014.648",

language = "English",

volume = "112",

pages = "660--666",

journal = "British Journal of Cancer",

issn = "0007-0920",

number = "4",

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Trillsch, F, Mahner, S, Vettorazzi, E, Woelber, L, Reuss, A, Baumann, K, Keyver-Paik, MD, Canzler, U, Wollschlaeger, K, Forner, D, Pfisterer, J, Schroeder, W, Muenstedt, K, Richter, B, Fotopoulou, C, Schmalfeldt, B, Burges, A, Ewald-Riegler, N, De Gregorio, N, Hilpert, F, Fehm, T, Meier, W, Hillemanns, P, Hanker, L, Hasenburg, A, Strauss, HG, Hellriegel, M, Wimberger, P, Kommoss, S, Kommoss, F, Hauptmann, S & du Bois, A 2015, 'Surgical staging and prognosis in serous borderline ovarian tumours (BOT): A subanalysis of the AGO ROBOT study', British Journal of Cancer, vol. 112, no. 4, pp. 660-666. https://doi.org/10.1038/bjc.2014.648

TY - JOUR

T1 - Surgical staging and prognosis in serous borderline ovarian tumours (BOT): A subanalysis of the AGO ROBOT study

AU - Trillsch, F.

AU - Mahner, S.

AU - Vettorazzi, E.

AU - Woelber, L.

AU - Reuss, A.

AU - Baumann, K.

AU - Keyver-Paik, M. D.

AU - Canzler, U.

AU - Wollschlaeger, K.

AU - Forner, D.

AU - Pfisterer, J.

AU - Schroeder, W.

AU - Muenstedt, K.

AU - Richter, B.

AU - Fotopoulou, C.

AU - Schmalfeldt, B.

AU - Burges, A.

AU - Ewald-Riegler, N.

AU - De Gregorio, N.

AU - Hilpert, F.

AU - Fehm, T.

AU - Meier, W.

AU - Hillemanns, P.

AU - Hanker, L.

AU - Hasenburg, A.

AU - Strauss, H. G.

AU - Hellriegel, M.

AU - Wimberger, P.

AU - Kommoss, S.

AU - Kommoss, F.

AU - Hauptmann, S.

AU - du Bois, A.

PY - 2015/2/17

Y1 - 2015/2/17

N2 - Background:Incomplete surgical staging is a negative prognostic factor for patients with borderline ovarian tumours (BOT). However, little is known about the prognostic impact of each individual staging procedure.Methods:Clinical parameters of 950 patients with BOT (confirmed by central reference pathology) treated between 1998 and 2008 at 24 German AGO centres were analysed. In 559 patients with serous BOT and adequate ovarian surgery, further recommended staging procedures (omentectomy, peritoneal biopsies, cytology) were evaluated applying Cox regression models with respect to progression-free survival (PFS).Results:For patients with one missing staging procedure, the hazard ratio (HR) for recurrence was 1.25 (95%-CI 0.66-2.39; P=0.497). This risk increased with each additional procedure skipped reaching statistical significance in case of two (HR 1.95; 95%-CI 1.06-3.58; P=0.031) and three missing steps (HR 2.37; 95%-CI 1.22-4.64; P=0.011). The most crucial procedure was omentectomy which retained a statistically significant impact on PFS in multiple analysis (HR 1.91; 95%-CI 1.15-3.19; P=0.013) adjusting for previously established prognostic factors as FIGO stage, tumour residuals, and fertility preservation.Conclusion:Individual surgical staging procedures contribute to the prognosis for patients with serous BOT. In this analysis, recurrence risk increased with each skipped surgical step. This should be considered when re-staging procedures following incomplete primary surgery are discussed.

AB - Background:Incomplete surgical staging is a negative prognostic factor for patients with borderline ovarian tumours (BOT). However, little is known about the prognostic impact of each individual staging procedure.Methods:Clinical parameters of 950 patients with BOT (confirmed by central reference pathology) treated between 1998 and 2008 at 24 German AGO centres were analysed. In 559 patients with serous BOT and adequate ovarian surgery, further recommended staging procedures (omentectomy, peritoneal biopsies, cytology) were evaluated applying Cox regression models with respect to progression-free survival (PFS).Results:For patients with one missing staging procedure, the hazard ratio (HR) for recurrence was 1.25 (95%-CI 0.66-2.39; P=0.497). This risk increased with each additional procedure skipped reaching statistical significance in case of two (HR 1.95; 95%-CI 1.06-3.58; P=0.031) and three missing steps (HR 2.37; 95%-CI 1.22-4.64; P=0.011). The most crucial procedure was omentectomy which retained a statistically significant impact on PFS in multiple analysis (HR 1.91; 95%-CI 1.15-3.19; P=0.013) adjusting for previously established prognostic factors as FIGO stage, tumour residuals, and fertility preservation.Conclusion:Individual surgical staging procedures contribute to the prognosis for patients with serous BOT. In this analysis, recurrence risk increased with each skipped surgical step. This should be considered when re-staging procedures following incomplete primary surgery are discussed.

UR - http://www.scopus.com/inward/record.url?scp=84923578781&partnerID=8YFLogxK

U2 - 10.1038/bjc.2014.648

DO - 10.1038/bjc.2014.648

M3 - Journal articles

C2 - 25562434

AN - SCOPUS:84923578781

SN - 0007-0920

VL - 112

SP - 660

EP - 666

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 4

ER -

Surgical staging and prognosis in serous borderline ovarian tumours (BOT): A subanalysis of the AGO ROBOT study

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