To the Editor: In their study, Dr Kim and colleagues1 frequently combined ovarian carcinomas with ovarian
"borderline tumors." This grouping is not valid. Although pathologists disagree
on terminology for "borderline tumors," they agree on the behavior of this
heterogeneous group. The vast majority (about 90%) of serous borderline tumors
(the most common type) are benign with virtually 100% survival.2
The aggressive serous borderline tumors have a micropapillary pattern and/or
invasive peritoneal implants, and patients with these tumors have a 7-year
survival of 60% to 70%.2 Mucinous borderline
tumors comprise nearly all the remaining borderline tumors, and aggressive
mucinous borderline tumors, previously thought to be ovarian, are now acknowledged
to be of gastrointestinal origin.2 The remaining
ovarian mucinous borderline tumors are virtually always confined to the ovaries
and patients have 100% survival.2 Thus,
the grouping of borderline tumors with carcinomas intermixes benign with malignant
tumors and renders the results uninterpretable.
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