Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 199

Borderline ovarian tumors (BOTs) are a subgroup of epithelial ovarian tumors with low malignancy potential. Histologically, they are characterized by cellular proliferation and nuclear atypia, but in the absence of identifiable stromal invasions [1]. They account for 10–20% of all ovarian tumors, and are particularly common in women of reproductive age, with approximately one‐third of all BOTs occurring in women under the age of 40 years [1].

In women who have completed childbearing, the optimal treatment for BOT is considered to be hysterectomy, bilateral salpingo‐oophorectomy, omentectomy and multiple peritoneal biopsies [2]. However, as they often occur in women of reproductive age, and generally have excellent survival prognosis, fertility‐preserving surgery is usually offered to women suspected to have BOTs. Fertility preservation involves preservation of at least part of one ovary, and the uterus. Laparoscopy is often the standard approach for surgery. Although the rate of recurrence is higher following conservative surgery, this does not result in a higher mortality rate [3].

BOTs are bilateral in 25–50% of cases. In such women, the fertility‐preserving surgical option is either bilateral cystectomies or unilateral oophorectomy plus contralateral cystectomy [4]. In women who have had a cystectomy, the risk of further BOT is high, and oophorectomy could be considered once childbearing is completed.