Sogc Guideline: Borderline Ovarian Tumours

Front 1

What percent of borderline/LMP ovarian tumours undergo malignant transformation?

Back 1

0.5%

- cf. 0.2-0.7% for fibroids

Front 2

What is the most common subtype of borderline tumours?

Back 2

- serous

- bilateral in >20% of cases
- majority present as Stage I

Front 3

How are borderline tumours staged?

Back 3

Same as epithelial ovarian cancer

Front 4

What benign tissue finding is associated w/ borderline tumours?

Back 4

endosalpingiosis (ectopic tubal tissue)

Front 5

What are prognostic factors for disease-free and long-term survival?

Back 5

- FIGO stage
- histological type (serous)
- age
- residual tumour
- surgical procedure
- tumour growth on ovarian surface
- pseudo-myxoma peritonei
- aneuploid tumours worse than diploid

- microscopic LN metastases do not alter the prognosis

Front 6

Principles to follow during surgery for borderline tumours (possibly found on frozen section)

Back 6

1. resect all visible disease
2. if the omentum is clinically uninvolved, an omental biopsy rather than omentectomy is sufficient
3. if mucinous borderline tumour, then appendectomy should be performed
4. no benefit in resecting clinically normal LNs
5. no benefit in removing clinically uninvolved tissue (eg. uterus and contralateral ovary)
6. no benefit in taking random peritoneal biopsies

Front 7

When to use post-op chemotherapy in borderline tumours?

Back 7

- only if there are:
- invasive implants
- micro-invasive disease in the primary tumour

- same as low-grade EOC

Front 8

What is the management of recurrent borderline tumour?

Back 8

- secondary cytoreductive surgery

- no role for chemotherapy