The usefulness of intraoperative consultation for the diagnosis of borderline ovarian tumors

Salcedo‐Hernández, Rosa A.; Cantú-de-León, David; Pérez-Montiel, Delia; García-Pérez, Leticia; Lino‐Silva, Leonardo S.; Zepeda-Najar, César; Barquet-Muñoz, Salim Abraham

doi:10.21037/atm-20-3932

Cited by 2 publications

(2 citation statements)

References 15 publications

(11 reference statements)

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“…Underdiagnosis occurred in 21% of cases (ovarian cancer was finally diagnosed), whereas overdiagnosis occurred in 6% of cases (benign lesions were finally diagnosed). A more recent study found that the accuracy of frozen section and paraffin blocks was 64.8%, with underdiagnosis in 27% of patients [18]. These discrepancies confirm the need to withhold the final decision on FSS until a diagnosis of BOT is obtained from paraffin blocks.…”

Section: Discussionmentioning

confidence: 95%

Obstetric outcomes after conservative management of ovarian borderline tumors in women of reproductive age: A single center experience

Sobiczewski

Piątek

Michalski

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective: The main goal of fertility-sparing treatment is pregnancy followed by live birth (i.e., successful pregnancy). The principal objective of our study was to evaluate the successful pregnancy rate in patients with borderline ovarian tumors (BOTs) after conservative treatment. The second goal was to evaluate the safety of the conservative approach. Study design: 110 patients with BOT were retrospectively evaluated. All patients underwent surgical treatment, sparing the uterus and part of at least one ovary. Results: The median age was 28 years (range 17-40 years). Serous and mucinous tumors were found in 63 (57%) and 34 (31%) women, respectively. FIGO stage I, II, and III was diagnosed in 101 (91.8%), 3 (2.7%), and 6 (5.5%) patients, respectively. The 3-and 5-year progression-free survival was 82.5% and 78.2%, respectively. Recurrent disease was treated conservatively in 14 women, whereas 3 patients underwent radical surgery. Fifty-six (50.9%) patients got pregnant and had at least one live birth. A total of 83 children were born. A significant difference in the successful pregnancy rate was found in patients diagnosed 35 years vs. > 35 years old (55.6% vs. 9.1%, respectively; p = 0.003). Surgical approach (laparoscopy vs. laparotomy) did not influence the chance of childbirth. Pre-term delivery constituted 6.25% of all births. Conclusions: Fertility-sparing surgery should be proposed to young women wishing to preserve fertility. The rate of spontaneous pregnancy is approximately 50%.The risk of relapse is significant but always of borderline histology and may be successfully treated by the second surgery.

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Section: Discussionmentioning

confidence: 95%

Obstetric outcomes after conservative management of ovarian borderline tumors in women of reproductive age: A single center experience

Sobiczewski

Piątek

Michalski

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Obtaining a biopsy for the histopathologic evaluation from a normal appearing contra-lateral ovary is not helpful to reduce the risk of recurrence; an accurate preoperative ultrasonographic examination and a careful intraoperative macroscopic inspection is considered adequate for this purpose ( 38 ).…”

Section: Surgical Approachmentioning

confidence: 99%

The challenging management of borderline ovarian tumors (BOTs) in women of childbearing age

et al. 2022

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Borderline ovarian tumors (BOTs) account for approximately 15% of all epithelial ovarian cancers. In 80% of cases the diagnosis of BOTs is done at stage I and more than a third of BOTs occurs in women younger than 40 years of age wishing to preserve their childbearing potential; the issue of conservative surgical management (fertility-sparing treatment) is thus becoming of paramount importance. At early stages, the modalities of conservative treatment could range from mono-lateral cystectomy to bilateral salpingo-oophorectomy. Although cystectomy is the preferred method to promote fertility it can lead to an elevated risk of recurrence; therefore, an appropriate counseling about the risk of relapse is mandatory before opting for this treatment. Nevertheless, relapses are often benign and can be treated by repeated conservative surgery. Besides the stage of the disease, histological subtype is another essential factor when considering the proper procedure: as most mucinous BOTs (mBOTs) are more commonly unilateral, the risk of an invasive recurrence seems to be higher, compared to serous histotype, therefore unilateral salpingo-oophorectomy is recommended. In the appraisal of current literature, this review aims to gain better insight on the current recommendations to identify the right balance between an accurate staging and an optimal fertility outcome.

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The usefulness of intraoperative consultation for the diagnosis of borderline ovarian tumors

Cited by 2 publications

References 15 publications

Obstetric outcomes after conservative management of ovarian borderline tumors in women of reproductive age: A single center experience

Obstetric outcomes after conservative management of ovarian borderline tumors in women of reproductive age: A single center experience

The challenging management of borderline ovarian tumors (BOTs) in women of childbearing age

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