Management of Ovarian Borderline Malignancy

Objective: Ovarian tumors of borderline malignancy are not as aggressive as, and tend to occur in younger patients than, their invasive counterparts. We retrospectively reviewed our experience to assess the safety of conservative management of patients with limited disease. Materials and Methods: The clinical and pathologic records of 57 patients with ovarian borderline malignant tumors from 1988 to 1998 were identified from the database of the Chang Gung Memorial Hospital, Taiwan. The International Federation of Gynecology and Obstetrics staging was retrospectively assigned, follow-up information was obtained, and clinicopathologic correlations were made. Results: Forty-three of the 57 patients (75.4%) were at stage Ia, six (10.5%) were at stage Ib, seven (12.3%) were at stage Ic, and only one (1.8%) was at stage IIIc. Forty-three patients (75.4%) had mucinous cystadenoma of borderline malignancy, while 14 (24.6%) had the serous type. Twenty-eight patients (49.1%) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy or bilateral oophorectomy. Twenty-four patients (42.1%) were treated with unilateral oophorectomy or unilateral salpingo-oophorectomy. Two patients (3.5%) underwent debulking surgery. Five patients (8.8%) underwent enucleation of the ovarian tumor. Five patients (8.8%) received chemotherapy after surgery. The median follow-up period was 44 months, and no recurrence was found. Conclusion: Conservative procedures appear to be warranted in young patients with clinically localized disease, which might preserve fertility and decrease surgical morbidity.