Borderline ovarian tumours: a review of the recent literature

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Abstract
Borderline tumors of the ovary are seen commonly in obstetrics and gynecology practices. This review will outline the most recent information regarding the epidemiology, molecular pathogenesis, pathology, and clinical management of these tumors. In the past, borderline ovarian tumors and invasive ovarian cancer were studied together, under the presumption that they represent a continuum of disease. This view is coming into question based on both epidemiological and molecular biological studies. Pathologists are increasingly able to identify poor prognostic histological features. This has not yet been translated into improved non-surgical therapy. Surgical management to excise all visible tumor remains the cornerstone of therapy. Because borderline ovarian tumors often occur in reproductive-age women, fertility is an important issue. Conservative surgery is safe in carefully selected patients. Our growing understanding of the relatively benign natural history of borderline ovarian tumors has allowed us to be more conservative in their surgical management, preserving fertility in many young women. A few women will be affected by a more virulent form of the disease with the potential to recur and cause death. The pathological features that identify patients with a poor prognosis are progressively being elucidated. Surgery remains the most effective therapy for these patients. Effective non-surgical therapies have yet to be identified. Hopefully, as molecular biological studies continue to expand our understanding of this disease as probably a separate carcinogenic process from invasive ovarian cancer, we will be able to employ this knowledge to design novel adjuvant therapies.