Treatment of borderline ovarian tumors

The treatment of ovarian diseases cannot be chosen arbitrarily, otherwise it will cause infertility in women, especially for women who have never given birth. It should be noted that the ovaries are prone to many types of diseases, and the causes of the diseases are related to women's own living habits. Therefore, women should also protect themselves well at ordinary times. What are the treatments for ovarian borderline tumors?

Treatment of borderline ovarian tumors:

The main treatment for borderline ovarian tumors is surgical treatment, and adjuvant therapy is not recommended except in special cases. What is significantly different from the past is that the concepts of microfocal infiltration and non-invasive implantation have been introduced, providing a basis for the treatment of borderline tumors.

1. Conservative surgery for borderline ovarian tumors Conservative surgery usually refers to resection of the affected side of the ovary and is suitable for young patients who want to have children. The surgery should meet the following conditions: ① The patient is young and eager to have children; ② It is confirmed to be stage I, and the contralateral ovary and fallopian tube are normal; ③ There are conditions for long-term follow-up after surgery. If a young patient has a tumor on one ovary, ascites or peritoneal lavage fluid is usually collected after laparotomy, and then one side of the ovary is removed first. If there is any suspicion during the dissection, frozen sections are sent. If the pathology report shows a borderline ovarian tumor, the contralateral ovary should be dissected and sent for pathological examination. At the same time, the pelvis and upper abdomen should be carefully explored. If there is no evidence of malignancy, no other surgery is required. The resected specimen should be examined by sectioning every 1 to 2 cm to determine whether there is invasion. If the postoperative paraffin section pathological examination shows cancer, ovarian cancer restaging surgery and/or chemotherapy can be performed according to the situation.

Buttini et al. retrospectively analyzed the data of 142 patients with stage I epithelial ovarian borderline tumors. Only one patient died of tumor after 29 months; 29 patients underwent conservative surgery, and only one patient had recurrence in the contralateral ovary, with a recurrence rate of 3.5%. This suggests that early-stage lesions can be treated with conservative surgery based on the patient's desire to preserve their fertility, without the need for adjuvant therapy. Patients with more advanced disease should undergo cytoreductive surgery, but whether lymph nodes should be removed is questionable because it is not related to survival.

Kennedy et al. explored the possibility of conservative surgery for patients with extraovarian lesions or advanced disease. Among the 76 patients with borderline serous tumors, 39/76 had extraovarian lesions, 28/74 were stage II or III patients, and 66 of them were followed up for 8 to 264 months (mean, 99 months). Only 1/66 (1.5%) had disease progression and died from widely disseminated serous carcinoma, and 2/18 (11.1%) who underwent routine conservative surgery had recurrence. Long-term follow-up showed that extraovarian lesions did not mean peritoneal implantation, and conservative surgery was feasible for young patients.

Some authors have also studied the recurrence rates of patients with borderline tumors after hysterectomy + bilateral oophorectomy, oophorectomy, and simple cystectomy, which were 5.7%, 15.1%, and 36.3%, respectively. However, conservative surgery can be performed again after recurrence, and pregnancy and long-term survival can still be achieved. Therefore, it is believed that although the risk of recurrence of conservative surgery is significantly increased, it does not affect the final survival. Even for patients in the late stage, there is a chance of achieving natural pregnancy after conservative surgery. Conservative surgery can be performed for young patients who wish to preserve their fertility, but close follow-up is required after surgery.

After understanding the treatment methods of ovarian borderline tumors, you can choose the above methods when treating ovarian borderline tumors. However, women need to pay attention to the fact that they should actively cooperate in the treatment of this type of disease and adjust their emotions. Don't be too excited, as this will not help the treatment of the disease.