Management of borderline ovarian tumours TOG 2012

Question 1

What are borderline ovarian tumours?

Answer 1

High proliferative activity
No stromal invasion

Question 2

What proportion of epithelial ovarian neoplasms?

Answer 2

10-15%
Typically seen in younger women

Question 3

5 year survival of borderline ovarian tumours?

Answer 3

Stage 1 95-97%
Stage 3 58-86%
Overall 70-80%

Question 4

Similarites and difference of RF to ovarian cancer?

Answer 4

More likely:
Younger women

Less likely:
Parous women
Lactation

COCP not protective
No influence of BRCA genes

Question 5

Gene mutation in boarderline tumours

Answer 5

BRAF/KRAS

(note in high grade serous - p53)

Question 6

Most common types of borderline ovarian tumours?

Answer 6

Question 7

What are mutinous borderline ovarian tumours associated with?

Answer 7

10% Pseudomyxoma pertinoei
Can be from mutinous tumour from appendix or ovary

Question 8

Management of borderline ovarian tumour

Answer 8

No need for chemotherapy

Question 9

What does complete staging surgery include?

Answer 9

exploration of the entire abdominal cavity with peritoneal washings

total abdominal hysterectomy
bilateral salpingo-oophorectomy and infracolic omen-tectomy

appendicectomy in the case of mucinous tumours

Consider lympdenectomy

Question 10

What portion of boarder at frozen section are later reclassified as invasive tumour?

Answer 10

1/3

Question 11

Conservative surgery includes

Answer 11

• Cystectomy or unilateral oophorectomy
• +/- infra colic omentectomy
• peritoneal washing

Question 12

Relapse rates after
- cystectomy
- salpingo-ooporecotomy
- radical Sx

Answer 12

• cystectomy 12-58%
• salpingo-ooporecotomy 0-20%
• radical Sx 2.5-6%

Recurrence borderline type

Question 13

Follow up?

Answer 13

Every 3 months for 2 years, then 6 month for 2 years then annually

Clinical examination and TVUS