Malignant Brenner tumors of the ovary; a population-based analysis

Malignant Brenner Tumor (MBT) is a tumor with an extremely low incidence that morphologically resembles to urothelium. Given the paucity of evidence on the epidemiology and prognosis of MBT, the aim of this retrospective population-based study was to elucidate the demographic and clinico-pathological characteristics of patients with ovarian MBT.

A cohort of patients diagnosed between 1988 and 2012 was drawn from the National Cancer Institute Surveillance and Epidemiology End Results database. For surgically treated patients, Observed and Disease Specific Survival were calculated following generation of Kaplan-Meier curves. Comparisons were made using the log-rank test.

A total of 207 patients were identified. Median patient age was 65years and the majority presented with unilateral, high grade tumors with a median size of 10cm. Stage I, II, III and IV disease was noted for 55.4%, 14.4%, 18%, and 12.2% of patients respectively. Only 5.1% had positive lymph nodes for metastatic disease. Five-year disease-specific survival (DSS) of patients with tumors confined to the ovary was 94.5% compared to 51.3% for those with extra-ovarian spread (p<0.001). Lymphadenectomy was not associated with an improved DSS (p=0.2).

MBTs are typically unilateral high grade tumors localized to the ovary. Regional lymphatic spread is uncommon and lymphadenectomy does not confer any improvement on survival. Patients with tumors confined to the ovary have an excellent prognosis while extra-ovarian spread is associated with a poor outcome.