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NCCN Guidelines for Patients



Ovarian Cancer, Version 1.2017


Treatment guide

Borderline epithelial tumors

Guide 20. Treatment for borderline epithelial tumors (LMP) tumor relapse

Follow-up results Next steps Treatment options

Clinical relapse

Relapse based on symptoms,

imaging test results, or

increase in CA-125 levels

• Surgical



• Debulking if



If no invasive implants

• Observe


If invasive implants or low-grade invasive


• See Guide 16

for grade 1 (low-grade)

serous epithelial carcinoma options


Invasive carcinoma (high-grade)

• See Part 5

for treatment of epithelial

ovarian cancer

Guide 20

shows the treatment options for an LMP

tumor that has come back after treatment. This is

called a recurrence or relapse. After a clinical

relapse, you may have surgery so that your doctor

can see where the tumor has spread. This is called

surgical evaluation. You may also have surgery to

remove as much of the tumor as possible. This is

called debulking surgery.

The treatment options for a relapse depend on

whether or not tumor cells have grown into (invaded)

nearby tissues. These are called invasive implants. If

there aren’t any invasive implants, then observation

with follow-up tests is recommended. If there are

invasive implants or invasive (high-grade) carcinoma,

then you have two treatment options to choose

from. One option is to have surgery followed by

chemotherapy, as described for primary treatment in

Part 5,

Treatment guide for epithelial ovarian cancer