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Improving the clinical management of women with borderline tumours: a recurrence risk scoring system from a French multicentre study
Author(s) -
Ouldamer L,
Bendifallah S,
Nikpayam M,
Body G,
Fritel X,
Uzan C,
Morice P,
Daraï E,
Ballester M
Publication year - 2017
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14577
Subject(s) - medicine , confidence interval , cohort , rss , serous fluid , gynecology , cohort study , obstetrics , computer science , operating system
Objective To develop a risk scoring system ( RSS ) for predicting recurrence in women with borderline ovarian tumours ( BOT s). Design Cohort study of women with BOT s. Setting French multicentre tertiary care centres. Population A cohort of 360 women with BOT s who received primary surgical treatment between January 2000 and December 2013. Methods Clinical and pathological factors affecting recurrence in women with BOT s. Main outcome measure The development of a model for the prediction of recurrence in women with BOT s. Results Overall the recurrence rate was 20.0% (72/360). Recurrence was associated with five variables: age < 45 years; preoperative serum tumour marker CA 125 > 150 IU / mL ; a serous histological subtype; International Federation of Gynecology and Obstetrics ( FIGO ) stage other than IA ; and ovarian surgery other than bilateral salpingo‐oophorectomy ( BSO ; i.e. cystectomy and unilateral salpingo‐oophorectomy). These variables were included in the RSS and assigned scores ranging from 0 to 6. The discrimination of the RSS was 0.82 (95% confidence interval, 95% CI 0.79–0.85). A total score of 8 points corresponded to the optimal threshold of the RSS , with a rate of recurrence of 11.8% (35/297) and 58.7% (37/63) for women at low risk (<8 points) and women at high risk (≥8 points), respectively. The diagnostic accuracy was 85.0%. Conclusions This study shows that the risk of BOT recurrence can be accurately predicted so that women at high risk can benefit from adapted surgical treatment. Tweetable abstract Our RSS permitted women with BOT s at low risk to be distinguished from women with BOT s at high risk of recurrence.