Ovarian Low Malignant Potential Tumours

• Ovarian low malignant potential tumour is a disease in which precancerous cells (cells that may, or are likely to, become cancer) form in the tissue covering the ovary.
• Certain factors affect prognosis (chance of recovery) and treatment options.
• In most cases, ovarian low malignant potential tumour can be treated successfully.

Ovarian low malignant potential tumour is a disease in which precancerous cells (cells that may, or are likely to, become cancer) form in the tissue covering the ovary.

Ovarian low malignant potential tumour is considered precancerous (or premalignant), a condition that may (or is likely to) become cancer. This disease seldom spreads beyond the ovary. When disease is found in one ovary, the other ovary also should be checked carefully for signs of disease.

The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a foetus grows). Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals that control the way certain cells or organs function).

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis and treatment options depend on the following:

• The stage of the cancer (whether it affects part of the ovary, involves the whole ovary, or has spread to other places in the body).
• The type of cancer.
• The size of the tumour.
• The patient’s general health.

In most cases, ovarian low malignant potential tumour can be treated successfully.

These tumours are usually found early. Most women, however, survive even advanced stage ovarian low malignant potential tumours. Patients who do not survive usually die from complications of the disease (such as a small bowel obstruction) or the side effects of treatment, but rarely because the tumour has spread.

Stages of Ovarian Low Malignant Potential Tumours

After ovarian low malignant potential tumour has been diagnosed, tests are done to find out if cancer cells have spread within the ovary or to other parts of the body. The process used to find out whether cancer has spread within the ovary or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Certain tests or procedures are used to determine stage. Staging laparotomy (a surgical incision made in the wall of the abdomen to remove ovarian tissue) may be used. Most patients are diagnosed with stage I disease.

(Refer to the summary on Ovarian Epithelial Cancer Treatment for information on the stages used for ovarian cancer.)

Recurrent Ovarian Low Malignant Potential Tumours

Recurrent ovarian low malignant potential tumour is cancer that has recurred (come back) after it has been treated. The cancer may come back in the other ovary or in other parts of the body.

Treatment Option Overview

Key Points for This Section

• There are different types of treatment for patients with ovarian low malignant potential tumour.
• Two types of standard treatment are used:
o Surgery
o Chemotherapy

• New types of treatment are being tested in clinical trials.

There are different types of treatment for patients with ovarian low malignant potential tumour.

Different types of treatment are available for patients with ovarian low malignant potential tumour. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Two types of standard treatment are used:

Surgery

The type of surgery (removing the tumour in an operation) depends on the extent of the disease and the woman’s plans for having children. Surgery may include the following:

• Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.
• Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.
• Total hysterectomy and bilateral salpingo-oophorectomy: A surgical procedure to remove the uterus, cervix, and both ovaries and fallopian tubes. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision (cut) in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
• Partial oophorectomy: A surgical procedure to remove part of one ovary or part of both ovaries.
• Omentectomy: A surgical procedure to remove the omentum (a piece of the tissue lining the abdominal wall).

Even if the doctor removes all disease that can be seen at the time of the operation, the patient may be given chemotherapy after surgery to kill any tumour cells that are left. Treatment given after the surgery to increase the chances of a cure is called adjuvant therapy.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

New types of treatment are being tested in clinical trials.

Information about ongoing clinical trials is available from the NCI Web site.

Treatment Options by Stage

Early Stage Ovarian Low Malignant Potential Tumours (Stage I/II)

Surgery is the standard treatment for early stage ovarian low malignant potential tumour. The type of surgery usually depends on whether a woman plans to have children.

For women who plan to have children, surgery is either:

• unilateral salpingo-oophorectomy; or
• partial oophorectomy.

To prevent recurrence of disease, most doctors recommend surgery to remove the remaining ovarian tissue when a woman no longer plans to have children.

For women who do not plan to have children, treatment may be hysterectomy and bilateral salpingo-oophorectomy.
Late Stage Ovarian Low Malignant Potential Tumours (Stage III)

Treatment for late stage ovarian low malignant potential tumour may be hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. A lymph node dissection may also be performed.

Treatment Options for Recurrent Ovarian Low Malignant Potential Tumours

Treatment for recurrent ovarian low malignant potential tumour may include the following:

• Surgery.
• Surgery followed by chemotherapy.