Management of borderline ovarian tumours

Best Pract Res Clin Obstet Gynaecol. 2017 May:41:49-59. doi: 10.1016/j.bpobgyn.2016.09.012. Epub 2016 Oct 3.

Abstract

Approximately 3000 American women are diagnosed with borderline ovarian tumours annually. Borderline tumours are similar to other types of adnexal masses. Prognostic factors include the International Federation of Gynecology and Obstetrics (FIGO) stage, presence of peritoneal implants, micropapillary pattern (for serous histology), microinvasion and intra-epithelial carcinoma (for mucinous histology). Approximately 65-70% of serous tumours and 90% of mucinous tumours are stage I, and 30% and 10%, respectively, are associated with extra-ovarian spread. Fertility-preservation counselling is recommended for young patients. Fertility-sparing surgery is feasible in a high proportion of women in the reproductive age group. Surgical staging generally includes resection of the primary borderline tumour, by either unilateral salpingo-oophorectomy or ovarian cystectomy, cytologic washings, omentectomy and peritoneal biopsies, and routine lymphadenectomy is not recommended. However, because the accuracy of frozen-section examination is lower than optimal, caution is recommended. Postoperative therapy is recommended only for those women with serous borderline tumours and invasive implants. Fortunately, relapse is uncommon.

Keywords: borderline ovarian tumours; fertility-sparing surgery; mucinous; serous.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Fertility Preservation / adverse effects
  • Fertility Preservation / methods*
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Neoplasm Staging
  • Neoplasms, Cystic, Mucinous, and Serous / mortality
  • Neoplasms, Cystic, Mucinous, and Serous / pathology
  • Neoplasms, Cystic, Mucinous, and Serous / surgery*
  • Ovarian Neoplasms / classification
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery*
  • Ovariectomy / adverse effects
  • Ovariectomy / methods*
  • Pregnancy
  • Prognosis
  • Salpingectomy
  • Treatment Outcome
  • Young Adult