Borderline Epithelial Ovarian Tumours

Abstract

EDITORIAL COMMENT: : We accepted this series of cases of ovarian tumours of borderline malignancy because the series is quite large and will interest readers. Stage 3 borderline ovarian lesions should be dealt with by the type of radical surgery reserved for frankly invasive ovarian cancer. The place of chemotherapy where the metastatic disease is histologically borderline in nature is still unclear although many would advocate its use. However when there is no evidence of spread beyond the ovary and the histology confirmed by an expert places the tumour in the borderline malignancy group, then no further therapy is indicated, even when the ovarian tumour is large. Alkylating agents used for chemotherapy have approximately a 10% long-term incidence of leukaemia and subsequent risk of death. There seems to be little point in having a classification of borderline malignancy if the patient is to be subjected to radical treatment in any case, even though the authors make the exception of the premenopausal patient who may wish to conceive. Proper staging at operation is important but it is also essential that the pathologist is an expert. In the Editors' experience there is usually only one or two such senior pathologists in any major city and usually pathologists are wise enough to make sure their local expert reviews the sections of all such cases. In this series a large proportion of the patients received radical surgery and chemotherapy as for ovarian carcinoma; although the results were exemplary, especially if one excludes the patient with the Stage 3 lesion, we consider that the treatment of Stage la ovarian borderline tumours does not require the use of adjuvant chemotherapy. Summary: : Twenty-four patients with borderline epithelial ovarian tumours treated in the Department of Obstetrics and Gynaecology of Hacettepe University during the last 12 years were evaluated with regard to histopathology, therapeutic modalities employed and outcome. No mortality was encountered among the 23 patients with Stage 1 disease, regardless of the surgical mode of treatment or adjuvant therapy. The related literature was reviewed briefly to help enlighten the controversial issue of borderline ovarian tumours.