IMR Press / EJGO / Volume 26 / Issue 5 / pii/2005212

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Distinguished Expert Series

Conservative management of epithelial ovarian cancer

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1 Department of Obstetrics and Gynecology, Institut Universitari Dexeus University of Barcelona, Barcelona (Spain)
Eur. J. Gynaecol. Oncol. 2005, 26(5), 473–478;
Published: 10 October 2005

We are currently faced with a progressive delay in the age at which women conceive for the first time This raises the possibility of the appearance of gynecologic  disorders that may affect fertility, including neoplasms of the ovary. Fertility-sparing surgery is defined as the preservation of ovarian tissue in one or both adnexa and/or the uterus. Borderline ovarian tumor should be treated with conservative surgery. Salpingo-oophorectomy, or even ovarian cystectomy, are the procedures of choice, with recurrence rates of 2-3% and up to 20% if a simple cystectomy is performed. Cystectomy is indicated in patients with bilateral borderline tumors or in patients with a residual ovary. Borderline tumors with invasive peritoneal implants behave as an invasive cancer in 10-30% of cases with a survival rate of 10-66% compared with 100% in borderline tumors without invasive implants. Prophylactic oophorec­tomy is recommended when desire of conception has been accomplished. Conservative surgery in invasive epithelial ovarian cancer is limited to Stage IA, grade 1 tumor, and in some highly selected grade 2 tumors of serous, mucinous or endometrioid type, well­encapsulated and free of adhesions. The standard oncological surgical procedure with preservation of the uterus and normal appear­ing ovary is recommended. This includes salpingo-oophorectomy, excision of any suspicious peritoneal lesion, multiple peritoneal biopsies, appendectomy (particularly in mucinous tumors), and pelvic and paraaortic lymphadenectomy.

Ovarian cancer
Surgery of the ovary
Conservative surgery of ovarian cancer
Borderline ovarian tumor
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