Borderline Ovarian Tumor · Fertility-Sparing vs Staging

Step-by-step decision

Choose step by step as prompted; reaching an endpoint gives the management recommendation. You can go back a step or restart anytime.

🎓 Want to practice? Do a case challenge with this pathway → (get a case, choose management step by step, scored).

Full pathway

1. [Decision] Fertility wish + stage + invasive implants
   Fertility-sparing? Stage? Invasive implants?
   • Young, wants fertility preservation → Young → fertility-sparing surgery
   • Completed childbearing → Completed childbearing → full staging
   • Advanced/invasive implants → Invasive implants → debulking + staging
2. [End] Young → fertility-sparing surgery
   Fertility-sparing surgery (ipsilateral adnexectomy or cystectomy + full staging, preserving uterus and contralateral adnexa); recurrence can be re-operated; close follow-up (CA125 + ultrasound).
3. [End] Completed childbearing → full staging
   Completed childbearing → full staging (total hysterectomy + bilateral salpingo-oophorectomy + omentectomy + peritoneal biopsies + washings); mostly good prognosis, usually no chemotherapy needed.
4. [End] Invasive implants → debulking + staging
   Advanced/invasive implants → debulking + full staging; invasive implants behave like low-grade malignancy, adjuvant therapy individualized (limited chemotherapy evidence).

Source guidelines & references

• Borderline ovarian tumor management (ESGO/NCCN; fertility preservation and staging)

This pathway is our own synthesis of the decision logic in the guidelines above (not the guideline verbatim); thresholds and workflows change as guidelines update — in practice follow the latest guideline, your institution's protocol and the individual patient.

Other pathways