Prognostic Factors of Bell et al for a Patient with an Ovarian Serous Borderline Tumor and Peritoneal Implants

Description

Bell et al evaluated women with serous borderline tumors of the ovary that show peritoneal implants. These can help distinguish women with a worse prognosis who may benefit from more aggressive management from those who have a benign course. The authors are from Massachusetts General Hospital.

Parameters:

(1) histologic invasion

(2) cytologic atypia

(3) mitotic activity in 10 high powered field

(4) gross evidence of residual tumor on completion of surgery

Parameter	Finding	Points
invasion	none (surface implant)	0
	present	1
cytologic atypia	minimal to moderate	0
	severe	1
mitotic activity	0 in 10 high powered fields	0
	>= 1 per 10 hpf	1
residual tumor	none	0
	present	1

where:

• Invasive implants show irregular, aggressive infiltration into the underlying tissue.

• Some noninvasive implants may show a desmoplastic stromal reaction to the tumor cells confined to the serosal surfaces and fibrous septa.

number of adverse prognostic factors =

= SUM(points for all 4 parameters)

Interpretation:

• minimum number: 0

• maximum number: 4

• Invasiveness and severe cytologic atypia are the most important for predicting outcome.

Limitations:

• The small number of deaths from tumor in the study limited data analysis.

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Description

Specialty

ICD-10