Tumores serosos borderline de ovário com implantes invasores e não invasores
Palavras-chave:
implantes peritoneais, neoplasias ovarianas, tumor borderline de ovárioResumo
Os tumores borderline de ovário compreendem 15% a 20% de todos os tumores ovarianos epiteliais malignos, sendo o tipo histológico seroso o mais freqüente. As mulheres que desenvolvem tumor borderline de ovário geralmente apresentam doença em estágio inicial, sobrevida longa e baixo risco de recorrência em comparação às que desenvolvem carcinomas. Entretanto, 15% a 30% dos tumores borderline de ovário serosos estão associados a implantes extra-ovarianos classificados em invasores e não invasores de acordo com sua apresentação histopatológica e aparecem mais comumente como implantes peritoneais. Este artigo de revisão tem o objetivo de caracterizar tumores borderline serosos com implantes invasores e não invasores. Esta revisão sistemática foi realizada por meio de consulta do sistema Medline (Pubmed) por meio das seguintes palavras-chave: tumor borderline de ovário, baixo potencial de malignidade, tumor de ovário, neoplasia de ovário e implantes peritoneais. Após rigorosa seleção, dez artigos publicados até maio de 2005 foram incluídos; foram avaliadas 404 pacientes com implantes invasores e não invasores. A média de idade foi de 25 a 42 anos. Cirurgia preservadora da fertilidade foi realizada em 2% a 100% dos casos. Dos implantes, 27% eram invasores e 73% não invasores. A média de seguimento das mulheres foi de 6,4 anos e no total foram documentados 32 (8%) óbitos pela doença. Mulheres com tumores borderline de ovário com implantes invasores têm pior prognóstico, o que reforça a necessidade de um meticuloso estadiamento cirúrgico da doença.
Downloads
Referências
Taylor HC. Malignant and semi- malignant tumors of the ovary. Surg Gynecol Obstet. 1929; 48:204-30.
Kottmeier HL. The classification and treatment of ovarian tumors. Acta Obstet Gynecol Scand. 1952; 31(3):313-63.
lnternational Federation of Gynecology and Obstetrics. Classification and staging of malignant tumors in the female pelvis. Acta Obstet Gynecol Scand. 1971; 50(1):1-7.
Kurman RJ, Trimble CL. The behavior of serous tumors of low malignant potential: are they ever malignant? lnt J Gynecol Pathol. 1993; 12(2):120-7.
Mink PJ, Sherman ME, Devesa SS. lncidence patterns of invasive and borderline ovarian tumors among white women and black women in the United States. Results from the SEER Program, 1978-1998. Cancer. 2002; 95(11):2380-9
Kurman RJ, Seidman JD, Shih IM. Serous borderline tumors of the ovary. Histopathology. 2005; 47(3):310-5.
Kaern J, Tropé CG, Abeler VM. A retrospective study of 370 borderline tumors of the ovary treated at the Norwegian Radium Hospital from 1970 to 1982. A review of clinicopathologic features and treatment modalities. Cancer. 1993; 71(5):1810-20.
Hopkins MP, Kumar NB, Morley GW. An assessment of pathological features and treatment modalities in ovarian tumors of low malignant potential. Obst Gynecol. 1987; 70(6):923-8 .
Gershenson DM. Is micropapillary serous carcinoma for real? Cancer. 2002; 95(4):677- 80
Piver MS, Goldberg JM, Tsukada Y, Mettlin CJ, Jishi MF, Natarajan N. Characteristics of familiai ovariancancer: a report of the first 1,000 families in the Gilda Radner Familiai Ovarian Cancer Registry. Eur J Gynecol Oncol. 1996; 17(3):169-76.
NIH consensus development panei on ovarian cancer: ovarian cancer: screening, treatment, and follow-up. JAMA. 1995, 273(6): 491-7
Piver MS, Jishi MF, Tsukada Y, Nava G. Primary peritoneal carcinoma after prophylactic oophorectomy in women with a family history of ovarian cancer. A report of the Gilda Radner Familiai Ovarian Cancer Registry. Cancer. 1993; 71(9):2751-5.
Purdie DM, Bain CJ, Siskind V, Webb PM, Green AC. Ovulation and risk of epithelial ovarian cancer. lnt J Cancer. 2003; 104(2):228-32.
Whittemore AS, Harris R, ltnyre J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case- contrai studies. The pathogenesis of epithelial ovarian cancer. Collaborative Ovarian Cancer Group. Am J Epidemiai. 1992; 136(10):1212-20.
Silverberg SG, Bell DA, Kurman RJ, Seidman JD, Prat J, Ronnett BM, et ai. Borderline ovarian tumors: key points and workshop summary. Human Pathol. 2004; 35(8):910-7.
Gershenson DM, Silva EG, Levy L, Burke TW, Wolf JK, Tornos C. Ovarian serous borderline tumors with invasive peritoneal implants. Cancer. 1998; 15,82(6):1096-103.
National Library of Medicine. MEDLINE . [Acessado em outubro de 2005]. Disponível em http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Rice LW, Berkowitz RS, Mark SD, Yavner DL, Lage JM. Epithelial ovarian tumor of borderline malignancy. Gynecol Oncol. 1990; 39(2):195-8.
Sykes PH, Quinn MA, Rome RM. Ovarian tumors of low malignant potential: a retrospective study in 234 patients. lnt J Gynecol Cancer. 1997; 7(3):218-26
Lackman F, Carey MS, Kirk ME, Mclachlin CM, Elit L. Surgery as sole treatment for serous borderline tumors of the ovary with noninvasive implants. Gynecol Oncol. 2003; 90(2):407-12
Deffieux X, Marice P, Camatte S, Fourchotte V, Duvillard P, Castaigne D. Results after laparoscopic management of serous borderline tumor of the ovary with peritoneal implants. Gynecol Oncol. 2005; 97(1):84-9.
Marice P, Camatte S, Rey A, Atallah D, Lhmmé C, Pautier P, Pomel C, et ai. Prognostic factors for patients with advanced stage serous borderline tumors of the ovary. Ann Oncol. 2003; 14(4):592-8.
Bell DA, Weinstock MA, Scully RE. Peritoneal implants of ovarian serous borderline tumors. Histologic features and prognosis. Cancer. 1988; 62(10): 2212-22.
Michael H, Roth LM. lnvasive and noninvasive implants in ovarian serous tumors of low malignant potential. Cancer. 1986; 57(6):1240-7.
Segai GH, Hart WR. Ovarian serous tumors of low malignant potential (serous border/ine tumors). The relationship of exophytic surface tumor to peritoneal "implants". Am J Pathol. 1992; 16(6):577-83.
Camatte S, Marice P, Pautier P, Atallah D, Duvillard P, Castaigne D. Fertility results after conservative treatment of advanced stage serous borderline tumour of the ovary. Br J Obstet Gynecol. 2002; 109(4):376-80.
Gershenson DM, Silva EG. Serous ovarian tumor of low malignant potential with peritoneal implants. Cancer. 1990; 65(3):578-85.
Lin PS, Gershenson DM, Bevers MW, Lucas KR, Burke TW, Silva EG. The current status of surgical staging of ovarian serous borderline tumors. Cancer. 1999; 85(4):905-11.
Gershenson DM, Silva EG, Tortolero-Luna G, Levenback C, Morris M, Tornos C. Serous borderline tumors of the ovary with noninvasive peritoneal implants. Cancer. 1998; 15:83(10):2157-63.
Prat J, Nictolis M. Serous borderline tumors of the ovary. A long-term follow-up study of 137 cases, including 18 with a micropapillary pattern and 20 with microinvasion. Am J Pathol. 2002; 26(9): 1111-28.
Bell KA, Smith Sehdev AE, Kurman RJ. Refined diagnostic criteria for implants associated with ovarian atypical proliferative serous tumors (borderline) and micropapillary serous carcinomas. Am J Pathol. 2001; 25(4):419-32.
Bell DA, Longacre TA, Prat J, Kahn EC, Soslow RA, Ellenson LH, et ai. Serous border!ine (low malignant potential, atypical proliferative) ovarian tumors: workshop perspectives. Human Pathol. 2004, 35(8): 934-48.
Seidman JD, Kurman RJ. Subclassification of serous borderline tumors of the ovary into benign and malignant types. A clinicopathologic study of 65 advanced stage cases. Am J Surg Pathol. 1996; 20(11):1331-45
Longacre TA, McKenney JK, Tazelaar HD, Kempson RL, Hendrickson MR. Ovarian serous tumors of low malignant potential (borderline tumors): outcome-based study of 276 patients with long-term (>or=5-year) follow-up. Am J Surg Pathol. 2005; 29(6):707-23.
