Management of borderline ovarian neoplasms
- PMID: 17617524
- DOI: 10.1200/JCO.2007.10.8076
Management of borderline ovarian neoplasms
Abstract
Over the last decades, the management of borderline ovarian tumors (BOTs) has changed from radical surgery to more conservative therapy as a result of the need for fertility-sparing surgery and the increasing use of laparoscopy. The question is whether this is good clinical practice from an oncologic point of view. Here, recent literature regarding management of borderline ovarian neoplasms is reviewed, and oncologic concerns are discussed with emphasis on the mode of surgery and the possibility of fertility-sparing surgery and its consequences. Proper staging is defined as an exploration of the entire abdominal cavity with peritoneal washings, infracolic omentectomy, and multiple peritoneal biopsies as the cornerstone of a successful treatment, and this is only possible through a midline incision. For stage I disease, conservative surgery consisting of unilateral salpingo-oophorectomy or cystectomy in case of bilateral ovarian involvement or when the disease develops in the only remaining ovary is a valuable alternative in a number of young patients who want to preserve their fertility. Patients with advanced-stage disease or who are finished childbearing are treated with radical surgery consisting of peritoneal washings, total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, complete peritoneal resection of macroscopic lesions, or multiple peritoneal biopsies; in case of mucinous BOTs, patients also are treated with an appendectomy.
Similar articles
-
Borderline ovarian tumors and fertility.Curr Opin Obstet Gynecol. 2010 Jun;22(3):227-34. doi: 10.1097/GCO.0b013e3283384928. Curr Opin Obstet Gynecol. 2010. PMID: 20386444 Review.
-
[Borderline Ovarian Tumours: CNGOF Guidelines for Clinical Practice - Therapeutic Management of Early Stages].Gynecol Obstet Fertil Senol. 2020 Mar;48(3):287-303. doi: 10.1016/j.gofs.2020.01.016. Epub 2020 Jan 28. Gynecol Obstet Fertil Senol. 2020. PMID: 32004786 French.
-
Laparoscopic fertility-sparing staging in unexpected early stage ovarian malignancies.Fertil Steril. 2009 Jun;91(6):2632-7. doi: 10.1016/j.fertnstert.2008.03.058. Epub 2008 Jun 13. Fertil Steril. 2009. PMID: 18555237
-
Conservative surgery for borderline ovarian tumors: a review.Gynecol Oncol. 2006 Jan;100(1):185-91. doi: 10.1016/j.ygyno.2005.09.021. Epub 2005 Oct 10. Gynecol Oncol. 2006. PMID: 16216320 Review.
-
Borderline ovarian tumors: French guidelines from the CNGOF. Part 2. Surgical management, follow-up, hormone replacement therapy, fertility management and preservation.J Gynecol Obstet Hum Reprod. 2021 Jan;50(1):101966. doi: 10.1016/j.jogoh.2020.101966. Epub 2020 Nov 2. J Gynecol Obstet Hum Reprod. 2021. PMID: 33144266
Cited by
-
Borderline tumours of the ovary, current controversies regarding their diagnosis and treatment.Ecancermedicalscience. 2013 Dec 17;7:379. doi: 10.3332/ecancer.2013.379. Ecancermedicalscience. 2013. PMID: 24386008 Free PMC article. Review.
-
Ovarian borderline tumors in the 2014 WHO classification: evolving concepts and diagnostic criteria.Virchows Arch. 2017 Feb;470(2):125-142. doi: 10.1007/s00428-016-2040-8. Epub 2016 Dec 27. Virchows Arch. 2017. PMID: 28025670 Free PMC article. Review.
-
Fertility preserving options in patients with gynecologic malignancies.Am J Obstet Gynecol. 2011 Aug;205(2):103-10. doi: 10.1016/j.ajog.2011.01.025. Epub 2011 Mar 16. Am J Obstet Gynecol. 2011. PMID: 21411052 Free PMC article. Review.
-
Factors associated with misdiagnosis of frozen section of mucinous borderline ovarian tumor.J Int Med Res. 2019 Jan;47(1):96-104. doi: 10.1177/0300060518795582. Epub 2018 Sep 9. J Int Med Res. 2019. PMID: 30198356 Free PMC article.
-
Effects of Infertility Drug Exposure on the Risk of Borderline Ovarian Tumors: A Systematic Review and Meta-Analysis.Biomedicines. 2023 Jun 26;11(7):1835. doi: 10.3390/biomedicines11071835. Biomedicines. 2023. PMID: 37509474 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical