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Abstract

Management of Borderline ovarian tumours

Borderline ovarian tumours (BOT) are defined as growths that have some, but not all, characteristics of malignant ovarian tumours. The decisive characteristic is the lack of a destructive invasion of the stroma. In most cases, ovarian carcinoma is in stage III/IV when diagnosed, while most BOT are diagnosed in stage I/II. The overall 15-year survival rate is around 99% for BOT diagnosed in stage I/II, falling to 30–50% for those diagnosed in stage III. In the presence of BOT, so-called peritoneal implants are frequently described, which are found at the outer surface with primary proliferations in 70–80% of cases. When implants are found it is important to determine their nature. Most implants are noninvasive, but in 6–10% of patients they are invasive, substantially lowering the survival rate. The therapy leans heavily on the clinical management of ovarian carcinoma and is directed at definitive staging, i. e. complete or maximum debulking. As the women affected are often young, it is essential to take account of any desire for children when surgery is planned and carried out. Routine performance of lymphadenectomy even when the lymph nodes are unremarkable cannot be recommended. As a rule no adjuvant therapy is indicated. Some authors recommend platinumcontaining chemotherapy if residual tumour persists after surgery or in the case of recurrence. After-care should continue to the end of each patient?s life.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2016; 12(2): 172–183

Keywords
Borderline ovarian tumour, management of borderline, prognose of borderline ovarian tumour, diagnosis of borderline ovarian tumour, treatment of borderline ovarian tumour

Luisa Kretzschmar1, Carsten Denkert2, Jalid Sehouli1
1 Klinik für Gynäkologie, Charité – Universitätsmedizin Berlin, Berlin
2 Institut für Pathologie, Charité – Universitätsmedizin Berlin, Berlin
Reviewer: Oumar Camara, Bad Langensalza,
und Jacek Grabowski, Berlin

Kretschmar L. Therapiemanagement ... Gynakol Geburtsmed Gynakol Endokrinol 2016; 12(2): 172–183 publiziert 31.7.2016 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2016 ISSN 1614-8533