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1203 Borderline ovarian tumor: management of recurrence after conservative surgical treatment
  1. Eya Ghorbeli1,
  2. Lamia Naija2,
  3. Nayssem Khessairi3,
  4. Fatma Saadallah2,
  5. Azza Chabchoub4,
  6. Montassar Ghalleb5,
  7. Maher Slimane6,
  8. Tarek Dhieb7 and
  9. Yoldez Houcine8
  1. 1Surgical Department Salah Azaiez Institute, Tunis, Tunisia
  2. 2Carcinologic Surgical Department, Salah Azeiz Institute, Tunis, Tunisia
  3. 3Surgical Oncology Department, Salah Azaiez institute, Tunis, Tunisia
  4. 4Salah Azaiez Institute, Tunis, Tunisia
  5. 5Surgery Department, Salah Azaiez Institute, Tunis, Tunisia
  6. 6Pathology Department Salah Azaiez Institute, Tunis, Tunisia
  7. 7Salah Azaiez Institute, Tunis, Tunisia
  8. 8Pathology Department Salah Azaiez Institute, Tunis, Tunisia

Abstract

Introduction/Background Borderline ovarian tumors account for 15 to 20% of ovarian tumors. Prognostic factors of recurrence include the stage of the disease, presence of peritoneal implants, micropapillary pattern, microinvasion and intra-epithelial carcinoma. Fertility sparing constitutes a major therapeutic issue in young patients that leads to conservative surgical treatment in specific cases.

Methodology We conducted a retrospective descriptive study including patients treated at our Institute for Borderline ovarian tumor who underwent conservative surgical treatment from 2003 to 2018.

Results Nine patients were included in our study. The median age was 33 years. Three patients were nulliparous. Given to the age, conservative treatment was indicated in all these patients. Cystectomy without ovariectomy was indicated in 5 of the 9 women, which was within the margin of tumor resection on definitive anatomopathic examination in 3 of the 5 women.In contrast, given the impossibility of ovarian conservation, total annexectomy was carried out in 4 of all these women. All of patients were followed regularly postoperatively, three had a carcinomatous transformation as an ovarian adenocarcinoma at an average interval of 18 months. Among these three patients, a single one presented intra-peritoneal metastases, requiring radical surgical treatment and adjuvant chemotherapy with 6 cures of Carbo-Taxol, with a good tolerance and a complete response. Moreover, one patient had a recurrence on the contralateral ovary as a Borderline mucinous ovarian tumor. For the remaining four women, after a median follow-up of 35 months, one patient fell spontaneously pregnant during follow-up, three patients were in complete remission at 16 months.

Conclusion Borderline ovary tumors usually occur in young patients, which makes conservative treatment advisable if possible, but this always comes with a risk of recurrence and/or carcinomatous transformation, especially if the conservative surgical procedure was a cystectomy instead of a total annexectomy, and even more so if the resection margins were tumoral.

Disclosures All authors declare that they have no conflicts of interest.

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