BORDERLINE OVARIAN-TUMORS

Borderline tumor of the ovary (BOT) is an epithelial tumor with a low rate of growth and a low potential to invade or metastasize. This tumo r often is associated with a significantly better prognosis than epith elial ovarian cancer. Most tumors are either serous or mucinous in his tology and present as early stage lesions. However, stage III lesions with peritoneal implants are not uncommon. Patients with early stage l esions have an excellent prognosis. Patients with higher stage lesions have a worse prognosis. Long-term follow-up of patients with BOT is r equired since the tumor can recur up to 20 years after the initial dia gnosis. Recently, investigators have begun to identify subsets of pati ents with a worse prognosis, such as patients with aneuploid tumors. T reatment for early stage lesions is surgical and conservative surgery can be accomplished successfully in younger patients who desire to mai ntain fertility. Treatment for later stage lesions has been approached in a variety of ways. All approaches initially begin with maximal cyt oreductive surgery. Studies suggest that early stage disease should be managed with surgery alone. Conflicting results on the usefulness of adjuvant therapy for patients with later stage disease have been obtai ned. At this time, the usefulness of adjuvant therapy for advanced dis ease remains undetermined. Further understanding of the basis of the d isease and analysis of specific higher risk subsets might identify pat ients in whom adjuvant therapy could be tested in the setting of contr olled clinical trials.