Recent updates in Management of Borderline Ovarian Tumors

Abstract

Borderline ovarian tumors (BOTs) need to be differentiated from ovarian carcinomas due to different presentation and management. Absent stromal invasion is the key differentiating feature on histopathological examination. Considering the degree of aggressiveness between epithelial ovarian carcinoma and benign ovarian neoplasms like cystadenoma, borderline neoplasms are closer to benign ovarian neoplasms as regards the clinical behavior. Surgery with intention of removal of all visible tumors is the most important pillar in treatment. Patients treated conservatively with fertility sparing surgery or laparoscopic surgery has low recurrence rate, making both options worth considering.Overall prognosis of these tumors is good with survival rate more than 90% at 10 years in early stage borderline tumors. However, small percentage of patients with borderline neoplasms may show more aggressive form of the disease, and trials have been made to figure out the histological correlates that might predict for worse outcome. There is no added advantage of postoperative adjuvant chemotherapy or radiation in any stage especially with non-invasive component. Follow up is done by observation of the patient and any further intervention is kept reserved for recurrent disease.