BORDERLINE AND INVASIVE EPITHELIAL OVARIAN-TUMORS IN YOUNG-WOMEN

Objective: To review the occurrence, morbidity, and mortality of borderline and invasive epithelial ovarian tumors in young women. Methods: We conducted a 15-year retrospective review of the case records of the Women's Cancer Center, University of Minnesota, and the JL McKelvey Tumor Registry. Results: We identified 67 patients under age 40 with borderline or invasive epithelial ovarian tumors. Fifty patients (75%) had borderline tumors and 17 (25%) had invasive tumors. The mean age at presentation was 31 years (range 14-39) for the borderline group and 34 years (range 23-39) for the invasive group. Pelvic pain and a palpable mass, present for less than 6 months, were the predominant presenting symptom and sign. There was no difference in the age at menarche between the patients with borderline (mean 12 years) and invasive tumors (mean 13 years). Fifty-seven patients were optimally cytoreduced to less than 2.0 cm after primary surgery. Thirty-five patients underwent second-look laparotomy, 15 of which were positive for tumor. A minority of patients in both groups had stage I tumors (17 in the borderline and one in the invasive group). Among patients with borderline tumors, there was no difference between ''very young'' and ''young'' patients in the stage at presentation or outcome. Similar proportions of patients presented with early- and late-stage disease. Three very young women (14%) and five young women (17%) have died. Among patients with invasive tumors, no difference existed between young and very young patients for stage at presentation, whereas grade and outcome differed significantly between the age groups (P < .05). Very young patients were more likely to present with grade 1 lesions, whereas patients aged 30-40 years were more likely to have grade 2 or 3 tumors (P < .05). Three (100%) of the very young patients have died, whereas seven (50%) of the young patients aged 30-40 years have died. The median survival of patients with borderline tumors was 36 months (range 2.0-150.5), significantly different from those with invasive tumors, whose median survival was 21 months (range 2.9-89.7) (P < .001). Conclusion: Borderline and invasive epithelial ovarian tumors are encountered in young women. Despite the implication of the term ''borderline,'' such tumors are associated with considerable morbidity and mortality.