Prognosis and management of borderline tumours of the ovary.

The 5-year survival for women with stage I borderline tumours is favourable, about 95-97%, but the 10-year survival is only between 70 and 95%, caused by late recurrence. The 5-year survival for stage II-III patients is 65-87%. A more correct staging procedure, classification of true serous implants and agreement on the contribution to stage of the presence of gelatinous ascites in mucinous tumours may in the future change the distribution of stage and survival data by stage for women with borderline tumours. Independent prognostic factors in patients with epithelial ovarian borderline tumours without residual tumour after primary surgery are DNA ploidy, International Federation of Gynecology and Obstetrics stage, histologic type and patient age. Future questions to be addressed include the following: (1) Have patients with borderline tumours in general been overtreated and how should these patients be treated?; (2) How to define the high-risk patient?; (3) In which group of patients is fertility-sparing surgery advisable?; and (4) Do patients with borderline tumours benefit from adjuvant treatment?