Clinical relevance of retroperitoneal involvement from epithelial ovarian tumors of borderline malignancy

Ovarian tumors of borderline malignancy have an outstanding prognosis. The need for aggressive surgical staging is questionable and the need for retro peritoneal node sampling is debated. From 1982 to 1996, 81 women underwent surgical staging including retroperit oneal sampling. Three patients (3.7%) with serous tumor had microscopic nod al involvement. Retroperitoneal metastases were found in two intraperitonea l stage I tumors and in one stage IIIA tumor. Positive nodes were found in 1/31 (3.2%) women undergoing sampling of para-aortic nodes and in 2/69 (2.8 %) women undergoing sampling of pelvic nodes. With a median follow-up of 79 months we observed five recurrences, but none involved the retroperitoneum . The three patients with positive nodes remain alive without disease. Amon g 236 patients with diagnosis of borderline tumor but without sampling of t he nodes, we observed one retroperitoneal recurrence (0.4%) in a serous tum or. There are no indications for retroperitoneal sampling of mucinous borde rline tumors. For serous tumors this procedure should only be performed as a part of prospective trials. The clinical relevance of retroperitoneal involvement in borderline tumors appears minimal and does not justify routine aggressive surgery.