Endometrioid Borderline Ovarian Tumor: Clinical Characteristics, Prognosis, and Managements

Giulio Ricotta; Maulard A; Amandine Maulard; Candiani M; Massimo Candiani; Scherrier S; Stephanie Scherrier; Catherine Genestie; Genestie C; Patricia Pautier; Pautier P; Leary A; Alexandra Leary; Cyrus Chargari; Chargari C; Mangili G; Giorgia Mangili; Philippe Morice; Morice P; Gouy S; Sébastien Gouy

doi:10.1245/s10434-022-11893-7

Endometrioid Borderline Ovarian Tumor: Clinical Characteristics, Prognosis, and Managements

Giulio Ricotta, Maulard A, Amandine Maulard, Candiani M, Massimo Candiani, Scherrier S, Stephanie Scherrier, Catherine Genestie, Genestie C, Patricia Pautier, Pautier P, Leary A, Alexandra Leary, Cyrus Chargari, Chargari C, Mangili G, Giorgia Mangili, Philippe Morice, Morice P, Gouy S, Sébastien Gouy

Annals of surgical oncology · 2022 · vol. 29(9) , pp. 5894–5903 · doi:10.1245/s10434-022-11893-7 · PMID:35590116

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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-12 ⓘ

This study reviewed 48 endometrioid borderline ovarian tumors, finding fertility-sparing surgery to be safe, a generally excellent prognosis with rare recurrence, and a high incidence of synchronous endometrial disease.

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This retrospective study analyzed 48 patients with endometrioid borderline ovarian tumor (EBOT) treated in or referred to two institutions, with centralized histopathology review, to characterize clinical features, management approaches (conservative surgery vs bilateral salpingo-oophorectomy), and oncologic outcomes. Most patients had stage I disease (43/48), with stromal microinvasion and intraepithelial carcinoma reported in 12% and 27% respectively; endometriosis was histologically associated in 25%, and synchronous endometrial disease was found in 24% of those evaluated. Median follow-up was 72 months, recurrence occurred in 5% after cystectomy, and no EBOT-related deaths were observed, with the authors noting that peritoneal restaging was relevant because some tumors were diagnosed at higher stage. Relevance to endometriosis: the paper reports histologic endometriosis association in 25% of EBOT cases and highlights synchronous endometrial disease in a substantial subset, though its main focus is clinical characteristics and prognosis of EBOT.

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Abstract

BACKGROUND: Endometrioid borderline ovarian tumor (EBOT) is a rare subtype of borderline ovarian malignancies. This study was designed to determine the prognosis of a series of EBOT. METHODS: This is a retrospective review of patients with EBOT treated in or referred to our institutions and a centralized, histological review by a reference pathologist. Data on the clinical characteristics, management (surgical and medical), and oncologic outcomes of patients were required for inclusion. RESULTS: Forty-eight patients were identified. Median age was 52 years (range 14-89). Fourteen patients underwent a conservative surgery and 32 a bilateral salpingo-oophorectomy (unknown in 2 cases). Two patients had bilateral tumors. Forty-three patients had stage I disease, and five patients had stage II disease (10%). Stromal microinvasion and intraepithelial carcinoma was observed in 6 (12%) and 13 (27%) patients respectively. Endometriosis was histologically associated in 12 patients (25%). Synchronous endometrial disease was found in 7 (24%) of 29 patients with endometrial histological evaluation. The median follow-up was 72 months (range 6-146). Two patients developed a recurrence after cystectomy in form of borderline disease (5%). No death related to EBOT occurred. CONCLUSIONS: Peritoneal restaging surgery should be performed if not realized initially, because 5% of EBOTS are diagnosed at stage II-III. Fertility-sparing surgery seems a safe option in selected patients. Because synchronous endometrial diseases, including endometrial carcinoma are frequent, systematic hysterectomy (or endometrial sampling in case of fertility-sparing surgery) is mandatory. Prognosis is generally excellent. Recurrence is a rare event (6%), but it can occur in the form of invasive disease.

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Abstract

Background Endometrioid borderline ovarian tumor (EBOT) is a rare subtype of borderline ovarian malignancies. This study was designed to determine the prognosis of a series of EBOT.

Methods

This is a retrospective review of patients with EBOT treated in or referred to our institutions and a centralized, histological review by a reference pathologist. Data on the clinical characteristics, management (surgical and medical), and oncologic outcomes of patients were required for inclusion.

Results

Forty-eight patients were identified. Median age was 52 years (range 14-89). Fourteen patients underwent a conservative surgery and 32 a bilateral salpingo-oophorectomy (unknown in 2 cases). Two patients had bilateral tumors. Forty-three patients had stage I disease, and five patients had stage II disease (10%). Stromal microinvasion and intraepithelial carcinoma was observed in 6 (12%) and 13 (27%) patients respectively. Endometriosis was histologically associated in 12 patients (25%). Synchronous endometrial disease was found in 7 (24%) of 29 patients with endometrial histological evaluation. The median follow-up was 72 months (range 6-146). Two patients developed a recurrence after cystectomy in form of borderline disease (5%). No death related to EBOT occurred.

Conclusions

Peritoneal restaging surgery should be performed if not realized initially, because 5% of EBOTS are diagnosed at stage II–III. Fertility-sparing surgery seems a safe option in selected patients. Because synchronous endometrial diseases, including endometrial carcinoma are frequent, systematic hysterectomy (or endometrial sampling in case of fertility-sparing surgery) is mandatory. Prognosis is generally excellent. Recurrence is a rare event (6%), but it can occur in the form of invasive disease. Similar content being viewed by others

References

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Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Ovarian Neoplasms

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