BORDERLINE OVARIAN-TUMORS

Our objective was to evaluate the sonographic features, serum tumor ma rkers in a serie of 43 patients with borderline ovarian tumors. At son ographic examination, the majority of borderline tumors were multilocu lar. Serum CA-125 levels were elevated In 32,1 %, CA-19-9 in 17,4 %. I n contrast, ACE levels were constently normal. Twenty-four out of 43 p atients (55,8 %) had serous tumors, 18 (41,9 %) had mucinous tumors an d 1 (2,3 %) had endometrioid tumor. Among, the 43 patients, 9 (20,9 %) had first iaparotomic approach and 34 had first laparoscopic treatmen t. Seven out of 34 patients treated by first laparoscopic approach had a laparoconversion (2 for presumption of invasive carcinoma and 5 for failure of laparoscopic procedure). Therefore, 27 had exclusive lapar oscopic managment. Among the 43 patients, 22 had conservative treatmen t and 21 radical surgery. The mean follow-up of patients was 41 months . Thirty-seven patients (86, 1 %) were alive without recurrence, 4 had a recurrence (9,3 %), 1 patient (2,3 %) was lost to follow-up and the last died of intercurrent disease. The mean delay of recurrence was 2 2 months (range 6 to 36). Three out of 4 recurrences occurred after cy stectomy (2 ipsilateral and 1 controlateral). The fourth recurrence oc curred after unilateral salpingo-oophorectomy. All 10 second look proc edures were negative. Our results point out about the feasibility of l aparoscopic managment of borderline tumors. However, cystectomy is ass ociated with a high risk of recurrence.