Tumores limítrofes de ovario (experiencia con 50 casos)

Abstract

IntroductionBorderline ovarian tumors are tumors with cell proliferation and nuclear atypia without stromal invasion, but with the ability to develop tumor implants, and recurrence probability up to 5 or more years after diagnosis. ObjectiveTo show the clinical and pathological aspects of diagnosis and treatment of these tumors through an institutional review of casuistry. MethodsRetrospective analysis of clinical records from borderline ovarian tumors managed with oncologic criteria in the Department of Oncology at Hospital General de Mexico “Dr. Eduardo Liceaga”, for a period of 5 years. ResultsWe treated 50 cases of 502 patients with epithelial ovarian cancer (9.9%); with a mean age of 45.8 years; the predominant clinical manifestations were pain and increased abdominal volume. Thirty-nine patients (78.0%) had serous tumors, 10 (20.0%) mucinous tumors; and 1 (2.0%) endometrioid tumor. Forty-one (82%) were classified in stage I; and 9 (18%) with stage II and III. Seventy one % of stage I and 88.8% of the stage II and III, had elevated Ca-125 (p>.05).In 18 of 33 patients (54.5%) the correct diagnosis was obtained by intraoperative study. Thirty seven patients of the study were treated with radical surgery (74%) and 13, with conservative (but comprehensive) surgical staging (26%). Only one case of nine (11.1%) with restaging showed substratification; and 1 out of 30 lymphadenectomies (3.3%) had lymph node involvement. Twelve cases (24%) showed tumor implants. In this series, there was no tumor recurrence during a mean follow-up of 32.6 months. ConclusionsManagement with oncologic criteria of these tumors corroborated that the majority corresponds to Stage I, and helps reduce the numbers of recurrences. The role of lymphadenectomy is still controversial.