What is the prevalence of inaccurate staging of borderline ovarian cancer?

Updated: Mar 18, 2019
  • Author: Andrew E Green, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

One study found that only 12% of patients were adequately staged at initial operation. Of these patients, 78% were operated on by general obstetrician/gynecologists, 10% by gynecologic oncologists, and 6% by general surgeons. When gynecologic oncologists were asked about surgical staging for borderline tumors, 97% recommended some type of staging procedure, although opinions varied significantly about which samples should be taken. [2]

In a study of stage I disease, all recurrences appeared in patients who were inadequately staged. Many, if not all, of these patients probably did not actually have stage I disease.

Pathologic diagnosis is difficult to confirm by frozen section. Borderline tumors are correctly diagnosed 58-86% of the time by frozen section, depending on the experience of the pathologist and the site of the operation (eg, tertiary care vs community hospital).

However, in one study at a tertiary referral center, benign disease was excluded in 94% of cases subsequently diagnosed as borderline tumor. Thus, the proper operation and staging procedures could have been performed during the initial operation in most cases, even though the diagnosis by frozen section was not completely accurate.


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