OVARIAN-TUMORS OF LOW MALIGNANT POTENTIAL - A RETROSPECTIVE STUDY OF 234 PATIENTS

Two-hundred and thirty-four consecutive patients with a histologic dia gnosis of low malignant potential (LMP) ovarian tumors between 1972 an d 1994 form the basis of this study. Six patients had a synchronous in tra-abdominal or pelvic malignancy and six were considered to have are as of early stromal invasion, these patients being considered separate ly. The patients ages ranged from 16-93 years. The histologic type was mucinous in 53%, serous in 37%, mixed in 7%, and other in 3%. Ovarian tumors were bilateral in 15% with mucinous and 39% with serous diseas e. Fourteen patients had pseudomyxoma peritonei. Extra ovarian disease was found in 28 (34%) patients with serous and 15 (13%) with mucinous tumors. Five (6%) patients with serous tumors had invasive implants a nd four had lymph node implants. Clinically 175 patients had stage I d isease, 19 had stage II and 28 stage III disease but only 88 patients were formally staged. Follow-up details were available for 173 (74%) p atients, ranging from 2 months to 20 years, mean 54 months. Thirteen p atients (6%) died of disease, of whom six had pseudomyxoma peritonei. Twelve patients (6%) had developed invasive malignancy of whom seven d ied. None of the patients with formally staged Ia or Ib disease had a recurrence. With the exception of patients with synchronous malignancy or pseudomyxoma peritonei the prognosis is good. Surgical staging off ers limited prognostic information but sacrifice of fertility is not j ustified. Adjuvant therapy is not indicated in early stage disease and its role for patients with extra ovarian disease remains controversia l.