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Title: Diagnosis and therapy in the case of ovarian tumors of borderline malignancy in patients treated in the Department of Gynecology and Oncology University Hospital in Krakow

Abstract:

Borderline ovarian tumors (BOT) are heterogeneous group of epithelial tumors with some unclear malignant potential, but without stroma invasion.The incidence of BOT varies between 12-15% of epithelial ovarian tumors (both BOT and ovarian carcinomas). Over the last fifty years the interest has increased from 5% to 25% of epithelial ovarian tumors. In contrary to ovarian cancers BOT are diagnosed 10 years earlier (45th vs. 55th year of life) and carry a good prognosis. Long-term overall survival (OS) in case of stage I FIGO (Fédération Internationale de Gynécologie et d'Obstétrique) is nearly 100% and in all stages of the disease around 95 - 97%. The basic treatment is surgery. Due to a very good prognosis it is important to know the potential side effects of the treatment options when deciding about the management.The aim of the study was the assessment of treatment outcomes, prognostic factors, quality of life (QoL) and fertility after conserving treatment of the patients’ population with BOT treated in Department of Gynecology and Oncology, University Hospital in Krakow.Basing on the available literature and our results predictive factors in terms of optimal treatment strategies for BOT were suggested. The diagnostic and treatment algorithm for BOT was presented.96 Patients treated due to BOT between years 2000 and 2012 were included into the study. The median age was 48 years. All patients underwent surgical procedures: 92 patients were treated radically, in 4 cases it was R2 resection. During the observation period 12 recurrences and 7 deaths were observed (including 2 related to recurrences/disease progression). 5, 10 and 15-year disease- free survival (DFS) with the usage of Kaplan-Meier method was 92,5%, 86% and 72%. There was statistically significant influence of type of conserving treatment and laparoscopic management, the presence of implants in peritoneum and tumor ≥ 10 cm on DFS. 5, 10 and 15-year OS was 94%, 92,5% and 87%. None of the patients that died underwent conservative surgery. The presence of implants (p = 0,005) and FIGO score > I (p = 0,01) had a negative impact on OS. No other factors influenced OS.In more than half of the patients diagnostic procedures were performed due to clinical symptoms. It seems that a greater awareness of the symptoms localize in the abdomen may increase the percentage of early detection of malignancies localized in the female reproductive organs. In the group of patients at the reproductive age treated with conserving intention 37% of women 89 reported spontaneous pregnancies. Survey studies revealed that 60.6% of patients estimated their QoL as comparable with their peers. No significant impact of the assessed parameters on QoL was reported. Only 21% of patients were aware of their diagnosis. The level of nescience about the nature of the disease clearly indicates the need for greater emphasis on informing the patients about the diagnosis. To evaluate the effect of BOT therapy on QoL it is necessary to conduct further studies.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

nowotwory ; ginekologia

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Wydział Lekarski.

Promoter:

Antoni Basta

Date issued:

2016

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:4141

Call number:

ZB-125992

ControlNumberVIRTUA:

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Language:

pol

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

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Last modified:

May 24, 2021

In our library since:

Mar 13, 2017

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Number of object content views in PDF format

10

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/4141

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ZB-125992 May 24, 2021
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