Management Dilemmas in Borderline Ovarian Tumor

Objective: Borderline ovarian tumors (BOT) constitute 15% of all epithelial ovarian cancers. The aim of this study is to analyze and discuss the management dilemmas associated with BOT. The purpose of this article was to collect and review the data on management dilemmas of BOT from numerous articles published since 1995. Additionally, the data of four patients with BOT, who were treated in our Institute, are presented and analyzed. Materials and Methods: For literature review we performed a literature search of relevant articles that were based on management dilemmas. Additionally, the data of 4 patients with BOT, who were treated in our Institute, are reported and reviewed by medical data information and patient interview, to establishing a database for a better understanding of the management dilemmas of BOT. Result: All the four cases were of reproductive age group. In three cases conservative fertility sparing surgery was done and in one patient radical surgery was done. All the four cases did not require adjuvant therapy. BOTs did not affect the outcome of pregnancy. Follow up of all the four cases is uneventful with no evidence of recurrence. Conclusion: Surgical management to excise all visible tumor tissue remains the keystone of therapy. Fertility being an important issue; conservative laparoscopic surgery is also a viable treatment option. Progression free survival is not influenced by the type of surgical approach (laparoscopic v/s laparotomy). Overall survival does not depend on the type of surgery (fertility sparing v/s non-sparing surgery). Even in advanced disease there is no proven benefit of adjuvant chemotherapy or radiotherapy. This tumor and the pregnancy are not influenced by each other.