time of surgery, a unilateral salpingo-oophorectomy (USO) is done and sent for
frozen section.
If the final pathology report of the enlarged adnexa was benign, the patient can
be followed up in the office on a yearly basis for regular examination. If the
pathology report was carcinoma, the patient can be followed up every three
months for the first two years and then every six months for the next two years
with follow-up of the CA-125 tumor marker.
Borderline Cancers. Another entity of ovarian cancer is the borderline tumors
also known as tumors of low malignant potential. These are characterized by no
invasion of the basement membrane and can also be treated conservatively.
Benign histology: If the patient is not a good surgical candidate or the patient
desires to maintain her uterus and contralateral ovary, a USO is sufficient
treatment. If the USO by frozen section is benign and the patient is a good
surgical candidate, then a TAH and BSO may be performed even though it is
benign disease because the uterus and ovaries are not unusual sites of
pathology in a woman.
Malignant histology: In this case, a debulking procedure (cytoreduction)
should be performed. This procedure consists of a TAH and BSO,
omentectomy, and bowel resection, if necessary. Postoperative chemotherapy
(carboplatin and Taxol) should be administered.Conservative surgery. A patient who desires further fertility with a unilateral
borderline cancer of the ovary can be treated with a USO with preservation of
the uterus and the opposite adnexa.
Aggressive surgery. If the patient has completed her family then the most
acceptable treatment would be a TAH and BSO.
Chemotherapy. Patients with borderline cancer of the ovary do not require