BORDERLINE AND INVASIVE EPITHELIAL OVARIAN-TUMORS IN YOUNG-WOMEN

Objective: To review the occurrence, morbidity, and mortality of borde rline 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 T umor Registry. Results: We identified 67 patients under age 40 with bo rderline or invasive epithelial ovarian tumors. Fifty patients (75%) h ad 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 palpa ble mass, present for less than 6 months, were the predominant present ing symptom and sign. There was no difference in the age at menarche b etween the patients with borderline (mean 12 years) and invasive tumor s (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 minori ty 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'' patient s in the stage at presentation or outcome. Similar proportions of pati ents presented with early- and late-stage disease. Three very young wo men (14%) and five young women (17%) have died. Among patients with in vasive tumors, no difference existed between young and very young pati ents for stage at presentation, whereas grade and outcome differed sig nificantly 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 t he young patients aged 30-40 years have died. The median survival of p atients with borderline tumors was 36 months (range 2.0-150.5), signif icantly different from those with invasive tumors, whose median surviv al was 21 months (range 2.9-89.7) (P < .001). Conclusion: Borderline a nd invasive epithelial ovarian tumors are encountered in young women. Despite the implication of the term ''borderline,'' such tumors are as sociated with considerable morbidity and mortality.