Clinical management of borderline ovarian tumors

Abstract

Borderline ovarian tumors (BOTs) are epithelial tumors of the ovaries characterized by cellular proliferation and nuclear atypia but without an infiltrative growth pattern. As they frequently affect younger patients the clinical management is complicated by considerations such as preserving fertility and reducing postoperative morbidity. Over the past several decades surgical therapy has shifted from a radical approach to more conservative treatment. There are various modes of surgery applied to the patients. All these developments have to be considered from an oncologic standpoint as BOTs represent a potentially malignant disease. Oncologic safety, as well as patients' desires and expectations, have to be balanced to reach the most appropriate treatment for BOTs. For this reason current literature will be discussed in this review to give a thorough overview of this topic and to develop recommendations for the surgical management of these patients. Open questions will be identified to elaborate the need for future surveys and research.

Twenty-five-year-old Woman with Bilateral Borderline Ovarian Tumour Desiring to Preserve Fertility – Case Report and Literature Review on the Current State of Fertility Preservation in Women with Borderline Ovarian Tumours

“…While the risk of borderline tumour recurrence is generally reported to be approx. 5 % after stage-appropriate surgery, this percentage can increase four-fold after fertility-preserving cystectomy such as that performed on our patient [11]. However, the literature also contains reports on the possibility of bilateral cystectomy in the case of bilateral ovarian involvement and explicit fertility-preserving desire.…”

Management of a borderline ovarian tumor in a pregnant woman in a rural hospital: a case report

“…Spontaneous conception is reported after conservative surgery in 50% of patients without any deterioration in the survival rate [27] . The available data suggest that the rate of recurrence is higher after conservative surgery (10% to 20% vs. approximately 5% for radical surgery) [22] . Nevertheless, the psychological impact of waiting for relapse is considerable and there is still a risk for development of invasive ovarian tumors, for this reason its recommend definitive surgery after family planning is completed [24] .…”

In Ovo Progression of Borderline Ovarian Tumors

“…BOTs are viewed as an intermediate state between benign cystadenomas and adenocarcinomas. BOTs represent 15-20% of epithelial ovarian carcinomas (EOC), and 80% of them are diagnosed during the early stages of development [2,3]. Most women are diagnosed around 40 years of age but this can vary depending on ethnicity and geography [4].…”