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Year: 2019
COI code: DTOGIMED03_130
Paper Language: English

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Akram Ghahghaei Nezamabadi - depatment of gyneoncology,tehran university of medcal science


Background and Aim : Borderline tumors of the ovary (also called tumors of low-malignant potential) area heterogeneous group of lesions defined histologically by atypical epithelial proliferation without stromalinvasion . The behavior of these tumors is distinct from low-grade ovarian carcinoma and they areconsidered a distinct clinical entity. Borderline tumors usually occur in young women and saving thefertility is an important issueMethods : Approximately one-third of women diagnosed with a borderline ovarian tumor are younger than40 years of age . This makes issues related to ovarian function and fertility preservation of increasedimportance. The majority of cases are diagnosed at stage one.Data are mixed regarding the associationbetween ovulation induction and borderline ovarian tumor.The choice of full staging or ovary-conservingsurgery is controversial. many young women desire to conserve at least one ovary to preserve fertilityand/or avoid the symptoms and effects of premature menopause . The disease has a good prognosis (stageI five-year survival is 99 percent) and unilateral salpingo-oophorectomy (USO) appears to be an option forwomen with unilateral disease . Some data suggest that ovarian cystectomy is also acceptable. Some datasuggest that USO is more effective than ovarian cystectomy, especially if the margins are positive . Forwomen with bilateral ovarian borderline tumors, oophorectomy on one side and cystectomy on the other isthe usual treatment approach. Laparotomy versus laparoscopy for treatment: A laparoscopic approach hasnot been evaluated in randomized trials. In general, retrospective series have reported that cyst rupture wasmore likely and complete staging was less likely with laparoscopic surgery than laparotomy, but there wasno difference in recurrence rate.Recurrence of borderline disease requires surgical resection, typically fullstaging. If no malignant disease is present, borderline recurrences are not associated with mortality. In somecases, even after a recurrence, the uterus and one ovary or part of an ovary may be conserved to retainfertilityResults : Unilateral salpingo-oophorectomy and bilateral cystectomy should be recommended as thepreferred choice of treatment for young patients with unilateral and bilateral borderline ovarian tumor whodesire to preserve fertility.Conclusion : Fertility counselling should become an integral part of the clinical management of womenwith BOT. Despite some epidemiological concerns on the possible relation between COH and BOT, theconservative surgical treatment should be associated to oocyte cryopreservation considering the high riskof recurrence of the disease


borderline tumor,ovary,fertility preservation

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COI code: DTOGIMED03_130

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Ghahghaei Nezamabadi, Akram, 2019, FERTILITY DEBATES IN BORDERLINE OVARIAN TUMORS, 3rd debatable topics on obstetrics gynecology & infertility, تهران, دانشگاه علوم پزشكي و خدمات بهداشتي و درماني شهيد بهشتي, the text, wherever referred to or an achievement of this article is mentioned, after mentioning the article, inside the parental, the following specifications are written.
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