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72

NCCN Guidelines for Patients

®

:

Ovarian Cancer, Version 1.2017

6

Treatment guide

Borderline epithelial tumors

Guide 19. Follow-up testing after treatment for borderline epithelial tumors

(LMP)

Follow-up tests and schedule

Follow-up visits every 3 to 6 months for 5 years, then once a year with:

• Physical exam and pelvic exam

• CA-125 blood test or other tumor markers as needed

• CBC and blood chemistry profile as needed

• CT, MRI, PET/CT of the chest, abdomen, and pelvis, or PET (bottom of the skull to mid-thigh) as needed

• Ultrasound as needed if you had fertility-sparing surgery

• Completion surgery, if you had fertility-sparing surgery and are finished having babies

Guide 18

shows adjuvant treatment options if

surgical staging was not complete. One option is to

have more surgery. Fertility-sparing surgery is an

option for patients with residual disease that remains

after surgical staging. If you don’t want to have

babies, then you may have completion surgery.

Completion surgery removes the remaining ovary (or

ovaries), fallopian tubes, uterus, omentum, and any

tumor cells found on nearby tissue. In some cases,

nearby lymph nodes may also be removed.

If invasive implants were found, chemotherapy is

another option for those who want or don’t want

fertility-sparing surgery. If no invasive implants were

found, no systemic treatment is recommended after

either surgery. You may begin observation or have

fertility-sparing surgery with removal of residual

disease.

Guide 19

shows the follow-up tests that are

recommended during observation and after primary

treatment for an LMP tumor. Observation is a period

of testing to watch for tumor growth. Follow-up

tests are given on a regular basis to watch for signs

that tumor cells have come back or spread after

treatment. Many of the follow-up tests are the same

as those used to find and confirm the tumor.

Follow-up visits are recommended every 3 to 6

months for 5 years. After that, they are recommended

once a year. A physical exam and pelvic exam should

be done at every follow-up visit. These exams help

your doctor check for physical signs that the tumor

has come back. Such signs may include swelling or

bloating in your belly, abnormal lumps, or sudden

changes in weight. Blood tests to measure CA-125 or

other tumor markers are recommended if levels were

high when the tumor was first found. Rising CA-125

levels after treatment may be an early sign that the

tumor has come back. A CBC measures the number

of each type of blood cell in a sample of blood. A

blood chemistry profile may be done to check the

health of certain organs and body systems.

Ultrasound uses sound waves to make pictures of

the inside of the body. It may be used to look for

signs of tumor growth if you had fertility-sparing

surgery. This type of surgery only removes one ovary

and its fallopian tube so that you will still be able to

have babies. Once you are finished having babies,

you should have completion surgery.