Borderline ovarian tumors, also called epithelial tumors of low malignant potential, have abnormal cells that may turn into cancer. This diagnosis makes up approximately 10 to 15 percent of all epithelial ovarian tumors, and the tumors are not invasive (Govindan, 2008). There are surgical treatments for these tumors as well as problems associated with the treatment.
General Information
Borderline ovarian tumors are usually found at an early stage, so treatment is highly successful. Even for those patients who are diagnosed at a later stage, treatment can be just as successful. It is rare for a woman to die from this tumor; rather, deaths are due to complications, such as a bowel obstruction or treatment side effects.
Surgery
Surgery and chemotherapy are the two standard treatments for borderline ovarian tumors. Women who want to preserve their fertility may have concerns about the extent of the surgery chosen. In order to avoid any potential problems, patients and doctors should discuss future childbearing plans and weigh the risks and benefits of different surgeries. Commonly, a unilateral or bilateral salpingo-oophorectomy (one or both ovaries and fallopian tubes, respectively, are removed) is performed. A total hysterectomy along with the bilateral salpingo-oophorectomy may be done, and this removes both ovaries and fallopian tubes along with the uterus and cervix. A partial oophorectomy removes part of one ovary or of both ovaries, and an omentectomy removes the omentum, which is a piece of tissue that is found on the abdominal wall lining.
Fertility
A question that patients need to think about when planning treatment for this tumor is whether they are done having children. For women who want to preserve their fertility, surgery consists of a unilateral salpingo-oophorectomy or partial oophorectomy. The other surgeries do not preserve fertility. To help prevent recurrence, it is recommended that the remaining ovarian tissue be removed when a woman does not plan on having any more children.
Considerations
A controversial topic in treating borderline ovarian tumors has been the surgically aggressive way they are treated. Many women who present with borderline ovarian tumors are young and want to preserve their fertility, but because these tumors are still treated like a subset of ovarian cancer, treatment tends to be aggressive moreso than often necessary.
Future Directions
Different types of borderline tumors should be treated according to how they behave at a cellular level, and new research is being published that distinguishes between the types. The categorization of borderline ovarian tumors is an old one and one that needs to be updated and revised. The surgical problems with these tumors lay in the ambiguity of the category itself, but with new research and treatments, these may be alleviated.
Tags: ovarian tumors, borderline ovarian tumors, both ovaries, preserve their, fertility, their fertility, these tumors