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Borderline Ovarian Cancer:

Explore the descriptive features and incidence trends of borderline ovarian cancer (LMP) in California, comparing them with invasive ovarian cancer. The study evaluates demographics, racial disparities, tumor size, staging, and survival rates, shedding light on the differences between LMP and invasive tumors.

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Borderline Ovarian Cancer:

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  1. Borderline Ovarian Cancer: Descriptive Features and Incidence Trends in California Cyllene Morris, DVM, PhD California Cancer Registry

  2. Background • Based on morphologic features, epithelial ovarian tumors classified as: • Benign • Borderline or Low Malignant Potential (LMP) • Malignant • Still unresolved: are LMP precursors of invasive ovarian cancer (OC) or separate entities? • Few serous LMP tumors progress to malignant OC, but some mucinous LMP tumors do.

  3. LMP tumors no longer reportable However • LMP tumors included in large screening trials in the US and UK LMP Tumors Still Collected in California

  4. LMP X Malignant Tumors • Both staged I – IV (AJCC and FIGO), based on tumor extension (nodes and tumor size do not affect stage) • LMP: node Involvement predicts recurrence, but not survival • Survival: distant stage LMP ≅ localized OC (excellent prognosis)

  5. Previous Studies • Similar epidemiologic features for LMP and invasive OC, except: • LMP: more likely among younger women • BRCA1 – BCRA2 mutations in 24.2% of invasive OC and 4.3% of LMP tumors (2005 Israeli study) • Oral Contraceptives: no protective effect for LMP?

  6. Objectives • Describe epidemiologic features of LMP tumors compared with invasive OC in California • Evaluate incidence trends of LMP tumors by race/ethnicity in the diverse California population

  7. Methods • 9,433 cases of LMP ovarian tumors diagnosed 1988-2009 (as of 03/31/10) • Microscopically confirmed • Cases detected through autopsy or death certificate only excluded • Incidence trends: JoinPoint (1988-2007)

  8. Invasive and LMP Ovarian Tumors: Demographics NH: Non-Hispanic PI: Pacific Islander

  9. Age-Specific Rates: Invasive and LMP Tumors, California, 1988-2007

  10. Age-Specific Rates: LMP Tumors

  11. Incidence Rates of Invasive and LMP Tumors: California, 1988 -2007

  12. JoinPoint Trends in the Incidence of LMP Tumors: California, 1988-2007

  13. Joinpoint trends in LMP tumors by Race/Ethnicity: California, 1988-2007

  14. Joinpoint trends in LMP tumors:Hispanic and African American Women

  15. AJCC Stage at Diagnosis of LMP and Invasive Tumors: California, 2000-2008

  16. Tumor SizeLMP: slightly larger than invasive tumors • LMP: 12.2 cm (4.8 inches) Invasive: 10.6 cm (4.2 inches) P-value < 0.001

  17. Invasive and LMP Tumors Laterality: California, 1988-200

  18. Relative 5-Year Survival for Invasive (by Stage) and LMP Tumors: California, 1988 -2008

  19. Relative 5-Year Survival for LMP Tumors, by Race/Ethnicity: California, 1988 -2008

  20. Conclusions • Substantial differences between Invasive and LMP tumors: • Age-specific rates • Race/Ethnicity: Hispanics 24% cases • Unlike invasive OC, incidence of LMP tumors among African American and Hispanic women • Even though majority of LMP tumors are Stage I, relative survival not 100%, and is lower among African Americans

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