Our Summary

This research paper looks at how often uterus involvement occurs in patients with borderline ovarian tumors, as well as the risk of recurrence and survival after a hysterectomy. The study took place in two French hospitals on women who had surgery for assumed stage I borderline ovarian tumors from 1997 to 2012. The patients were broken up into two groups: those who had surgery to spare their fertility and those who had radical surgery.

Out of 135 patients, 35 had fertility sparing surgery, 81 had radical surgery with a hysterectomy, and 19 had a previous hysterectomy for other reasons. The results showed that there were more recurrences of borderline ovarian disease and more cases of invasive ovarian disease in the group that had fertility sparing surgery.

It was also found that having a hysterectomy seemed to favorably affect survival without the disease, but it’s possible the perceived benefits could be due to the removal of both fallopian tubes and ovaries, not directly from the hysterectomy itself.

FAQs

  1. What demographic was this study conducted on for borderline ovarian tumors?
  2. What were the comparative results between those who had fertility sparing surgery and those who had radical surgery?
  3. Did having a hysterectomy directly affect survival without the disease or was it the removal of both fallopian tubes and ovaries?

Doctor’s Tip

A helpful tip a doctor might give to a patient undergoing a radical hysterectomy for borderline ovarian tumors is to discuss the potential benefits and risks of the surgery, including the impact on fertility and the possibility of recurrence. It is important for the patient to understand that a radical hysterectomy may be necessary to remove all cancerous tissue and reduce the risk of recurrence, but it may also have long-term implications for their reproductive health. Patients should also be encouraged to follow up with their healthcare provider regularly for monitoring and support after the surgery.

Suitable For

Based on the findings of this study, it can be inferred that patients with borderline ovarian tumors who are at a higher risk of recurrence or invasive disease may be recommended to undergo radical hysterectomy. This may be especially true for patients who have completed childbearing or do not wish to preserve fertility, as the removal of the uterus may help to reduce the risk of disease progression and improve overall survival.

Additionally, patients with other gynecologic conditions or risk factors that may increase the likelihood of ovarian or uterine involvement, such as a history of pelvic inflammatory disease or endometriosis, may also be recommended for radical hysterectomy. Overall, the decision to recommend radical hysterectomy for patients with borderline ovarian tumors will depend on individual factors such as age, overall health, desire for future fertility, and the extent of disease involvement. Consulting with a gynecologic oncologist or specialist in the field is crucial to determine the most appropriate treatment plan for each patient.

Timeline

Before radical hysterectomy:

  • Patient is diagnosed with borderline ovarian tumor
  • Patient undergoes surgery for assumed stage I borderline ovarian tumor
  • Patient is informed of their treatment options, including fertility sparing surgery or radical surgery
  • Patient may undergo pre-operative testing and preparations for surgery
  • Patient may discuss the potential risks and benefits of a hysterectomy with their healthcare provider

After radical hysterectomy:

  • Patient undergoes radical surgery, including a hysterectomy, to remove the uterus, cervix, and surrounding tissues
  • Patient may experience pain, discomfort, and recovery time post-surgery
  • Patient may undergo follow-up appointments and monitoring for recurrence or complications
  • Patient may experience changes in their physical and emotional well-being due to the removal of reproductive organs
  • Patient may receive additional treatments or therapies, depending on the stage and type of ovarian tumor
  • Patient may work with their healthcare team to manage any long-term side effects or complications from the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about radical hysterectomy include:

  1. What is the reason for recommending a radical hysterectomy in my case?
  2. What are the potential risks and complications associated with a radical hysterectomy?
  3. How will my quality of life be affected after a radical hysterectomy?
  4. Will I still be able to have children after a radical hysterectomy?
  5. What is the likelihood of recurrence or spread of the disease after a radical hysterectomy?
  6. Are there any alternative treatments or procedures that could be considered instead of a radical hysterectomy?
  7. How long is the recovery period after a radical hysterectomy?
  8. Will I need any additional treatments or follow-up care after the surgery?
  9. How will a radical hysterectomy affect my hormone levels and menopausal symptoms?
  10. Are there any long-term effects or implications of having a radical hysterectomy?

Reference

Authors: Ouldamer L, Lacoste C, Cormier B, Arbion F, Marret H, Jallais L, Fignon A, Body G. Journal: Surg Oncol. 2016 Mar;25(1):1-5. doi: 10.1016/j.suronc.2015.11.004. Epub 2015 Nov 12. PMID: 26979634