EPV205/#458 The follow up management of borderline ovarian tumours: a 10-year experience

This article reports the case of a 40 year old woman who presented to the gynaecologic outpatient clinic with pain lower abdomen and an abdominopelvic lump. Clinical assessment, biochemical and radiological investigations revealed bilateral complex ovarian masses. Surgical exploration and histology of ovarian masses confirmed a rare bilateral borderline seromucinous cystadenoma. The purpose of this paper is to highlight the importance of thorough examination of women with symptoms of ovarian tumour which can be vague and to emphasize the necessity of a good collaboration between various medical specialties (primary physician/gynaecologist, oncosurgeon, radiologist and histopathologist) for correct diagnosis, optimum care and best outcome. This article also provides overview of the pathology and biology of borderline ovarian tumours, diagnosis, principles of surgical management and to appreciate the value of follow up.

Download Full-text

S3-Guideline on Diagnostics, Therapy and Follow-up of Malignant Ovarian Tumours

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0033-1350713 ◽

2013 ◽

Vol 73 (09) ◽

pp. 874-889 ◽

Cited By ~ 22

Author(s):

U. Wagner ◽

P. Harter ◽

F. Hilpert ◽

S. Mahner ◽

A. Reuß ◽

...

Keyword(s):

S3 Guideline ◽

Ovarian Tumours

Download Full-text

Biochemical Markers in Ovarian Cancer: Possibilities and Limitations

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456328201900414 ◽

1982 ◽

Vol 19 (4) ◽

pp. 258-262 ◽

Cited By ~ 5

Author(s):

W G Haije

Keyword(s):

Ovarian Cancer ◽

Biochemical Markers ◽

Clinical Chemistry ◽

Acute Phase Reactant ◽

Alkaline Phosphatases ◽

Ovarian Tumours ◽

Tumour Antigens ◽

Epithelial Tumours ◽

Epithelial Ovarian Tumours

Cancer of the ovary is the commonest cause of death from gynaecological neoplasms. As ovarian tumours are relatively inaccessible, there is a great need for methods to improve early diagnosis and to assist with the management of patients with this disease. In this presentation the state of the art is discussed with regard to the usefulness of the presently recognised ‘tumour antigens’ and other biochemical markers in ovarian cancer. Of the oncodevelopmental antigens, only alpha fetoprotein and chorionic gonadotropin are well established as good markers in tumours with, respectively, yolk sac and trophoblastic elements. Carcinoembryonic antigen seems from our own experience to be an unreliable marker in cancer of the ovary. In epithelial tumours, which constitute the majority of ovarian malignancies, mostly serous and mucinous cystadenocarcinomas, some tumour products have been described, which may have potential as a marker, for example, ovarian cancer associated antigens, some glycoprotein glycosyltransferases, and also carcinoplacental alkaline phosphatases (CPAP). Recently, in patients with epithelial ovarian tumours attending our institute, multiple biochemical markers have been studied, including CPAP, phosphohexose isomerase, and some acute phase reactant proteins. The preliminary results, which will be discussed, show that longitudinal studies of some of these markers could have clinical application in follow-up. It must be concluded that, in spite of all efforts so far, and although some markers may become useful, early detection of ovarian cancer is a goal still to be reached by clinical chemistry in the field of oncology.

Download Full-text

Non-Epithelial Ovarian Cancer, an Experience From Qatar

10.21203/rs.3.rs-109259/v1 ◽

2020 ◽

Author(s):

Ammar Madani ◽

Nabil Omar ◽

Hafedh Ghazouani ◽

Cicy Jacob ◽

Aladdin Kanbour ◽

...

Keyword(s):

Early Stage ◽

Good Prognosis ◽

Stage I ◽

P Value ◽

Ovarian Cancers ◽

Fertility Sparing ◽

Ovarian Tumours ◽

Epithelial Ovarian Tumours ◽

Yolk Sac Tumour

Abstract Background: Nonepithelial Ovarian cancers constitute about 10 % of all ovarian cancers. They are divided into Sex-cord stromal tumours (SCST) and Germ cell tumours (GCT). The Aim is to report the experience at National Centre for Cancer Care and Research (NCCCR) in Qatar. Method: This is a retrospective study reviewing records of all patients over 7 years who presented with a histopathologically diagnosed ovarian SCST and GCT at NCCCR between January 2010 and December 2016. Results: 25 women with Non-Epithelial Ovarian Tumours were identified. 13 women were diagnosed with Ovarian SCST. Median age at presentation was 43 years (Range 16-58). 12 patients had stage I and one patient had Stage III. Four patients had recurrence. The 5 years Overall Survival (OS) was 100% and the 5 years Event Free Survival (EFS) was 69% with P value of 0.02. GCT was diagnosed in 12 women. The median age at presentation was 24 years. (Range 16 – 44). Seven patients (59 %) had teratoma, four patients (33 %) had Dysgerminoma and one patient had Yolk sac tumour (8 %). There was one recurrence. 5 years OS was 100 % and 5 years EFS was 83 % with P value of 0.14. Conclusions: Non-Epithelial ovarian tumours are diagnosed relatively at an early stage and have very good prognosis even if they recur. Survival in our study was excellent with all patients alive and disease free at last follow up. For ovarian SCST, we recommend Complete Surgery (TAH + BSO) particularly if high grade, Stage IC and above or completed childbearing to minimize recurrence. Fertility sparing surgery is appropriate for all patients with Stage I Ovarian GCT and most of the patients with Stage II disease who desire fertility preservation.

Download Full-text

Borderline ovarian tumours-patterns of recurrence and fertility outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174150 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4269

Author(s):

Dhanya Dinesh ◽

Rema Prabhakaran Nair ◽

Suchetha Sambasivan ◽

Aswin Kumar ◽

Iqbal M. Ahamed

Keyword(s):

Univariate Analysis ◽

Entire Study ◽

Factors Affecting ◽

Non Invasive ◽

Peritoneal Implants ◽

Fertility Sparing ◽

Ovarian Tumours ◽

Regional Cancer Centre ◽

Patterns Of Recurrence

Background: The aim of the study was to evaluate the factors affecting recurrence and prognosis in patients with borderline ovarian tumours and to assess the fertility outcome in women treated with conservative surgery.Methods: Fifty-six patients diagnosed with borderline ovarian tumours during the period between January 2005 and December 2009 in Regional Cancer Centre (RCC), Thiruvananthapuram were included. Patients were followed till December 2012.Results: Median follow up period was 52.5 months. The mean age at diagnosis was 33.5 yrs. Histopathology was serous in 41.1%, mucinous in 57.1%, and endometrioid in 1.8%. 48 patients (85.7%) had stage I disease, 2 patients (3.6%) had Stage II disease and 6 patients (10.7%) had stage III disease at diagnosis. 11 patients (19.6%) had bilateral tumours of which 7(63.6%) were serous and 4 were mucinous. 27 patients (48.2%) underwent fertility sparing surgery of which 13 patients underwent cystectomy and 14 underwent ovariotomy. 29 patients (51.78 %) underwent complete surgery including hysterectomy, bilateral salpingo oopherectomy and omentectomy. 14.3% of patients had microinvasive disease and 14.3 % had micro papillary disease on histopathology. 9 patients (16.1 %) had peritoneal implants of which 1 was invasive and 8 were non-invasive. Recurrence rate in the entire study group was 30.4%, 14.28% among patients undergoing complete surgery, 28.57% among patients undergoing adnexectomy and 69.2% among patients undergoing cystectomy.Conclusions: Univariate analysis showed a significant association between micropapillary histology, peritoneal implants and recurrence. On multivariate analysis, only peritoneal implants were found to be independently associated with recurrence.

Download Full-text

OC12.02: Management of borderline ovarian tumours: overall survival and long‐term follow‐up

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.20500 ◽

2019 ◽

Vol 54 (S1) ◽

pp. 29-30

Author(s):

S. Saso ◽

B. Jones ◽

M. Chawla ◽

E. Patterson ◽

K. Grewal ◽

...

Keyword(s):

Overall Survival ◽

Ovarian Tumours ◽

Long Term Follow Up

Download Full-text

Single centre experience of ovarian germ cell tumours over 8 years

10.1055/s-0039-1685316 ◽

2016 ◽

Author(s):

P. Veena

Keyword(s):

Germ Cell ◽

Germ Cell Tumour ◽

Reproductive Function ◽

Tumour Marker ◽

Germ Cell Tumours ◽

Malignant Tumours ◽

Fertility Sparing ◽

Ovarian Tumours ◽

Benign Tumours

Introduction: Germ cell tumours comprise approximately 15-20% of all ovarian tumours. Two third of ovarian tumours in first two decades of life are germ cell tumours. Majority of ovarian germ cell tumours are benign teratomas. The malignant germ cell tumours are usually solid and arise from totipotent germ cells. Over the past 3 decades the clinical outcome of women with ovarian germ cell tumours (OGCT) have significantly improved mainly due to development of more effective chemotherapy regimens. Objective: To study the clinic pathological features, treatment and survival of women with ovarian germ cell tumours. Methods: This is a retrospective descriptive study taken from the case files of patients with histo-pathologically proven ovarian germ cell tumours who were treated in JIPMER over 8 years from 2007 to 2014. Results: There were totally 63 patients with ovarian germ cell tumours over 8 years who were treated in JIPMER. The age at presentation varies from 12 years to 65 years with a median age of 26.5 years. Three were pre pubertal and 1 was post-menopausal. Twenty two women (34%) were unmarried and 5 were pregnant at the time of presentation. Forty eight (76%) of them did not have any menstrual abnormalities. Pain abdomen (55%) was the most common presentation. Ten of them presented with acute abdomen of which 8 were torsion, 1 was ruptured dermoid and 1 was infected dermoid. Another 6 patients had torsion which was diagnosed only during surgery. Majority (68%) were benign tumours (dermoid) and among malignant tumours, there were 6 dysgerminomas, 5 immature teratomas, 5 mixed germ cell tumours and 4 yolk sac tumours. Almost half (22 out of 43) of women with benign tumours were <25 years whereas 3/4th (14 out of 20) of women with malignant germ cell tumours were <25 years. The most common tumour marker which was elevated was alpha feto protein (8) followed by LDH (5). Fertility sparing surgery (salpingo-ovariotomy) was commonly performed which was 95% (41/43) in benign tumours and 60% (8/20) in malignant tumours. Contra lateral ovary was biopsied in only 5 patients with suspected involvement (negative on final HPR). Out of 20 women with malignant ovarian tumours 7 were in advanced stage (Stage III). Majority of them recovered well from surgery, only 12% had post-operative febrile morbidity and one patient had subclavian vein thrombosis on post op D9 which required anticoagulants. 7 of 20 women received chemotherapy (BEP) for 4 cycles. No serious side effects of chemotherapy were noted in these women. 3 out of 20 women with malignant germ cell tumour were lost to follow up. No recurrences have been found in rest of the women and there are no deaths till last follow up. Conclusion: Advances in the field of medicine like effective chemotherapy regimens, improved imaging, precise surgical staging and fertility sparing surgical procedures enable women not only to preserve the reproductive function but also to improve their quality of life.

Download Full-text

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

Download Full-text