Abstract

Borderline ovarian tumors are the epithelial neoplasm which need to be differentiated from ovarian carcinomas as there presentation and management differs from the latter. The important differentiating feature on histopathological examination is the absence of stromal invasion. In the spectrum of aggressiveness between epithelial ovarian carcinoma and benign ovarian tumors such as cystadenoma, borderline tumors are closer to benign ovarian tumors in their clinical behavior. Surgery with intention of removal of all visible tumors is the mainstay of the treatment. Low recurrence rate for patients treated conservatively with fertility sparing surgery and good results with laparoscopic surgery makes them viable options as per the circumstances. Overall prognosis of these tumors is good with survival rate more than 90% at 10 years in early stage borderline tumors but small fraction of patients with borderline tumors may exhibit more aggressive course, and attempts have been made to identify histological correlates that might predict for worse outcome. There is no added advantage of postoperative adjuvant chemotherapy or radiation in any stage especially with non invasive component. Observation is the mainstay of follow-up and any further intervention is kept reserved for recurrent disease. The aim of this article is to discuss the current literature regarding epidemiology, pathology, diagnosis, prognosis, recurrence trend and management recommendations with emphasis on areas of controversies and future prospects.