Review of outcomes of Borderline Ovarian Tumors

Abstract

BOTs constitute a group of epithelial tumours that can affect women of reproductive age who have excellent prognosis due to the low aggressiveness and the fact that they are largely diagnosed in initial stages. Conservative surgery of fertility is possible in select cases with disease limited to the ovary and when there is a strong desire to become a mother. Radical surgery of maximum cytoreduction is the goal of treatment in women with advanced or recurrent diseases. Residual disease following surgery and the presence of invasive peritoneal implants are the main prognostic factors. The benefits of adjuvant chemotherapy are limited by the fact that its use is still inadvisable. The follow-up of patients must be done up to 15 years following the initial diagnosis. Abdominal masses in young women require evaluation with ultrasound.Ovarian masses with internal septae even in the absence of solid component in the mass require follow up till resolution. Persistent masses of ovary call for tumor marker estimation .Ovarian cysts in young women which are associated with elevated levels of tumor markers and ascites require evaluation with M.R.I. Pelvis. MRI Abdomen is useful in detecting extent of disease in the abdomen.In the absence of extra ovarian disease on MRI. Abdomen and absence of malignant cells in ascitic fluid, still the diagnosis of Border line ovarian tumors should be kept in mind and staging laporotomy and frozen section evaluation of mass should be planned. In young women, who are yet to have children, unilateral salpingo oophorectomy with careful evaluation of other ovary should be done in unilateral Borderline ovarian tumor of the ovary.These women should be counseled for the need for a long term follow-up, early child bearing and possibility of recurrence.