Facteurs pronostiques et traitements des tumeurs frontières de l'ovaire (TFO) de stade avancé

Objective. The aim of this review is to study the incidence, the prognostic factors and the treatment of patients with «advanced stage» borderline ovarian tumor (BOT) associated with extra-ovarian disease (peritoneal implants and/or nodal disorders). Methods. Review of literature datas. Results. BOT were associated with peritoneal implants in 15% to 40%. The strongest prognostic factors are the histologic subtype of peritoneal implants and the presence of residual disease. The surgical treatment is the gold standard with resection of all peritoneal disease. This surgery could be conservative in selected cases in order to preserve fertility. Noninvasive peritoneal implants do not seem to be chemosensitive lesions. Conclusion. Histologic subtype of peritoneal implants is the most important prognostic factors in patients with serous BOT and extra-ovarian spread. The prognosis of patients with noninvasive implants is good. Treatment is based on surgery. The (only) indication of adjuvant therapy is BOT associated with invasive implants.