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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1450461
This article is part of the Research Topic Insights, Controversies, and New Developments in the Initial Treatment Decisions for Advanced Epithelial Ovarian Cancer View all 5 articles

Incidental Findings of Borderline Ovarian Tumor or Ovarian Cancer -Real-World Data on Surgical and Oncological Outcomes

Provisionally accepted
Carmen Joder Carmen Joder 1*Celine Smaadahl-Wey Celine Smaadahl-Wey 2Lara Zumwald Lara Zumwald 1Flurina Saner Flurina Saner 2Claudia Rauh Claudia Rauh 2Seline Hofer Seline Hofer 2Julian Wampfler Julian Wampfler 3Saskia Schlootz Saskia Schlootz 3Tilman Rau Tilman Rau 4Lucine Christe Lucine Christe 4Wiebke Solass Wiebke Solass 4Sara Imboden Sara Imboden 2Michael D. Mueller Michael D. Mueller 2Franziska Siegenthaler Franziska Siegenthaler 2
  • 1 University of Bern, Bern, Switzerland
  • 2 Department of Obstetrics and Gynecology, University Hospital Bern, Bern, Bern, Switzerland
  • 3 Department of Medical Oncology, Bern University Hospital, Bern, Bern, Switzerland
  • 4 Institute of Tissue Medicine and Pathology, University of Bern, Bern, Bern, Switzerland

The final, formatted version of the article will be published soon.

    Introduction Centralisation of ovarian cancer treatment is associated with higher rates of optimal surgery and longer survival. However, preoperative diagnosis of ovarian cancer is challenging and some diagnoses are made incidentally after surgery. This study investigated the surgical and oncological outcomes of patients with incidental findings of borderline ovarian tumors or ovarian cancer who were centralized postoperatively and treated with a two-stage surgical procedure, and compared these with those of patients with adnexal masses of suspected malignancy who were offered a single-stage surgical procedure with intraoperative frozen section in a tertiary hospital. Methods A database of 390 patients with adnexal masses and surgical treatment at the Bern University Hospital, Switzerland was retrospectively reviewed to identify patients with borderline ovarian tumors or ovarian cancer between 2010 and 2020. Results Among 390 patients with adnexal masses, 223 were diagnosed with a borderline ovarian tumor or ovarian cancer. Compared with patients with suspected malignancy and a centralized singlestage surgical procedure, patients with an incidental postoperative malignancy diagnosis and a twostage surgical procedure underwent more surgical interventions (1.3 vs. 2.1 p<.001) and had a longer time interval from diagnosis to initiation of chemotherapy (33.3 vs. 45.1 p=.005) and to completion of surgical cytoreduction (31.9 vs. 73.7 days, p<.001). However, there were no differences in the rates of complete cytoreduction (90.0% vs. 93.2%, p=.719), intraoperative (11.3% vs. 13.7%, p=.664) or postoperative (38.7% vs. 37.0%, p=.884) complication rates, and number of hospitalization days (11.1 vs. 12.0 days, p=.369). An incidental diagnosis of malignancy with postoperative referral was neither associated with an increased risk of recurrence (hazard ratio (HR) 0.8, 95% confidence interval (CI) 0.6-1.8, p=.839) nor death (HR 0.7, 95% CI 0.4-1.1, p=.113), and there was no difference in mean recurrence-free survival between the study subgroups. Discussion Although patients with incidental findings of borderline ovarian tumors or ovarian cancer treated with a two-stage surgical procedure had a longer time to completion of surgical staging and initiation of chemotherapy, our results showed no negative impact on oncological outcomes.

    Keywords: ovarian cancer, Borderline ovarian tumor, Centralized care, Surgical cytoreduction, surgical morbidity, Oncological outcome

    Received: 17 Jun 2024; Accepted: 17 Sep 2024.

    Copyright: © 2024 Joder, Smaadahl-Wey, Zumwald, Saner, Rauh, Hofer, Wampfler, Schlootz, Rau, Christe, Solass, Imboden, Mueller and Siegenthaler. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Carmen Joder, University of Bern, Bern, Switzerland

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