General Information About Ovarian Low Malignant Potential Tumors
Stages of Ovarian Low Malignant Potential Tumors
Recurrent Ovarian Low Malignant Potential Tumors
Treatment Option Overview
Treatment Options for Ovarian Low Malignant Potential Tumors

Early Stage Ovarian Low Malignant Potential Tumors (Stage I and II) Late Stage Ovarian Low Malignant Potential Tumors (Stage III and IV) Recurrent Ovarian Low Malignant Potential Tumors

To Learn More About Ovarian Low Malignant Potential Tumors
Get More Information From NCI
Changes to This Summary (09/12/2008)
About PDQ

General Information About Ovarian Low Malignant Potential Tumors

Key Points for This Section

Ovarian low malignant potential tumor is a disease in which abnormal cells form in the tissue covering the ovary. Certain factors affect prognosis (chance of recovery) and treatment options. In most cases, ovarian low malignant potential tumor can be treated successfully.

Ovarian low malignant potential tumor is a disease in which abnormal cells form in the tissue covering the ovary.

Ovarian low malignant potential tumors have abnormal cells that may become cancer, but usually do not. This disease usually remains in the ovary. When disease is found in one ovary, the other ovary should also 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 fetus 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 work).

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

The prognosis and treatment options depend on the following:

• The stage of the disease (whether it affects part of the ovary, involves the whole ovary, or has spread to other places in the body).
• What type of cells make up the tumor.
• The size of the tumor.
• The patient’s general health.

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

These tumors are usually found early. However, even advanced stage ovarian low malignant potential tumors can be treated successfully. 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 tumor has spread.

Stages of Ovarian Low Malignant Potential Tumors

Key Points for This Section

After ovarian low malignant potential tumor has been diagnosed, tests are done to find out if abnormal cells have spread within the ovary or to other parts of the body. The following stages are used for ovarian low malignant potential tumor: Stage I Stage II Stage III Stage IV

After ovarian low malignant potential tumor has been diagnosed, tests are done to find out if abnormal cells have spread within the ovary or to other parts of the body.

The process used to find out whether abnormal cells have 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.

The following stages are used for ovarian low malignant potential tumor:

Stage I

In stage I, the tumor is found in one or both of the ovaries. Stage I is divided into stage IA, stage IB, and stage IC.

• Stage IA: The tumor is found in a single ovary.
• Stage IB: The tumor is found in both ovaries.
• Stage IC: The tumor is found in one or both ovaries and one of the following is true:
  • abnormal cells are found on the outside surface of one or both ovaries; or
  • the capsule (outer covering) of the tumor has ruptured (broken open); or
  • tumor cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity).

Stage II

In stage II, the tumor is found in one or both ovaries and has spread into other areas of the pelvis. Stage II is divided into stage IIA, stage IIB, and stage IIC.

• Stage IIA: The tumor has spread to the uterus and/or the fallopian tubes (the long slender tubes through which eggs pass from the ovaries to the uterus).
• Stage IIB: The tumor has spread to other tissue within the pelvis.
• Stage IIC: The tumor has spread to the uterus and/or fallopian tubes and/or other tissue within the pelvis and tumor cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity).

Stage III

Enlarge

Pea, peanut, walnut, and lime show tumor sizes.

In stage III, the tumor is found in one or both ovaries and has spread to other parts of the abdomen. Stage III is divided into stage IIIA, stage IIIB, and stage IIIC.

• Stage IIIA: The tumor is found only in the pelvis, but tumor cells have spread to the surface of the peritoneum (tissue that lines the abdominal wall and covers most of the organs in the abdomen).
• Stage IIIB: The tumor has spread to the peritoneum but is 2 centimeters or smaller in diameter.
• Stage IIIC: The tumor has spread to the peritoneum and is larger than 2 centimeters in diameter and/or has spread to lymph nodes in the abdomen.

The spread of tumor cells to the surface of the liver is also considered stage III disease.

Stage IV

In stage IV, tumor cells are found in one or both ovaries and have metastasized (spread) beyond the abdomen to other parts of the body.

The spread of tumor cells to tissues in the liver is also considered stage IV disease.

Ovarian low malignant potential tumors almost never reach stage IV.

Recurrent Ovarian Low Malignant Potential Tumors

Ovarian low malignant potential tumors may recur (come back) after they have been treated. The tumors 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 tumor. Two types of standard treatment are used: Surgery Chemotherapy New types of treatment are being tested in clinical trials. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their treatment. Follow-up tests may be needed.

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

Different types of treatment are available for patients with ovarian low malignant potential tumor. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer, tumors, and related conditions. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Two types of standard treatment are used:

Surgery

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

• Unilateral salpingo-oophorectomy: Surgery to remove one ovary and one fallopian tube.
• Bilateral salpingo-oophorectomy: Surgery to remove both ovaries and both fallopian tubes.
• Total hysterectomy and bilateral salpingo-oophorectomy: Surgery 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: Surgery to remove part of one ovary or part of both ovaries.
• Omentectomy: Surgery 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 tumor 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 them 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 clinical trials is available from the NCI Web site ¹.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the medical research process. Clinical trials are done to find out if new treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for disease are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way diseases will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Patients can enter clinical trials before, during, or after starting their treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose disease has not gotten better. There are also clinical trials that test new ways to stop a disease from recurring (coming back) or reduce the side effects of treatment.

Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the disease may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the disease has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

Treatment Options for Ovarian Low Malignant Potential Tumors

A link to a list of current clinical trials is included for each treatment section. For some stages, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Surgery is the standard treatment for early stage ovarian low malignant potential tumor. 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.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I borderline ovarian surface epithelial-stromal tumor ² and stage II borderline ovarian surface epithelial-stromal tumor ³.

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

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III borderline ovarian surface epithelial-stromal tumor ⁴ and stage IV borderline ovarian surface epithelial-stromal tumor ⁵.

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

• Surgery.
• Surgery followed by chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent borderline ovarian surface epithelial-stromal tumor ⁶.

To Learn More About Ovarian Low Malignant Potential Tumors

For general cancer information and other resources from the National Cancer Institute, see the following:

• What You Need to Know About™ Cancer - An Overview ⁷
• Understanding Cancer Series: Cancer ⁸
• Staging: Questions and Answers ⁹
• Chemotherapy and You: Support for People With Cancer ¹⁰
• Radiation Therapy and You: Support for People With Cancer ¹¹
• Coping with Cancer ¹²
• Support and Resources ¹³
• Cancer Library ¹⁴
• Information For Survivors/Caregivers/Advocates ¹⁵

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Changes to This Summary (09/12/2008)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Editorial changes were made to this summary.

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ¹⁷. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site ¹⁹. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy.

Cancer that has spread to other places in the body and usually cannot be cured or controlled with treatment.

Surgery to remove both ovaries and both fallopian tubes.

The long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel. Also called the intestine.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

In medicine, a sac of tissue and blood vessels that surrounds an organ, joint, or tumor. A capsule is also a form for medicine that is taken by mouth. It usually has a shell made of gelatin with the medicine inside.

A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.

The lower, narrow end of the uterus that forms a canal between the uterus and vagina.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

In medicine, a medical problem that occurs during a disease, or after a procedure or treatment. The complication may be caused by the disease, procedure, or treatment or may be unrelated to them.

The process of identifying a disease, such as cancer, from its signs and symptoms.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.

The developing offspring from 7 to 8 weeks after conception until birth.

Liquid.

Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.

One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.

Surgery to remove the uterus and, sometimes, the cervix. When the uterus and the cervix are removed, it is called a total hysterectomy. When only the uterus is removed, it is called a partial hysterectomy.

A cut made in the body to perform surgery.

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

A thin, tube-like instrument used to look at tissues and organs inside the abdomen. A laparoscope has a light and a lens for viewing and may have a tool to remove tissue.

A surgical incision made in the wall of the abdomen.

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. For a regional lymph node dissection, some of the lymph nodes in the tumor area are removed; for a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed. Also called lymphadenectomy.

To spread from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like those in the original (primary) tumor.

NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. It conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://www.cancer.gov. Also called National Cancer Institute.

Blockage of a passageway.

Surgery to remove part or all of the omentum.

A fold of the peritoneum (the thin tissue that lines the abdomen) that surrounds the stomach and other organs in the abdomen.

A part of the body that performs a specific function. For example, the heart is an organ.

Having to do with the ovaries, the female reproductive glands in which the ova (eggs) are formed. The ovaries are located in the pelvis, one on each side of the uterus.

A condition in which cells that may become cancer form in the thin layer of tissue that covers an ovary (female reproductive gland in which eggs are made). In this condition, tumor cells rarely spread outside of the ovary. Also called ovarian borderline malignant tumor.

One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.

Surgery to remove part of one ovary or part of both ovaries.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

The lower part of the abdomen, located between the hip bones.

The space within the abdomen that contains the intestines, the stomach, and the liver. It is bound by thin membranes.

The tissue that lines the abdominal wall and covers most of the organs in the abdomen.

The likely outcome or course of a disease; the chance of recovery or recurrence.

To come back or to return.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

Treatment with anticancer drugs directed to a specific area of the body.

The organs involved in producing offspring. In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). In men, it includes the prostate, the testes, and the penis.

A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spinal column encloses the spinal cord and the fluid surrounding the spinal cord. Also called spine, backbone, and vertebral column.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

The tumor is found in one or both ovaries. Stage I is divided into stages IA, IB, and IC. In stage IA, the tumor is found in a single ovary. In stage IB, the tumor is found in both ovaries. In stage IC, the tumor is found in one or both ovaries and one of the following is true: (1) abnormal cells are found on the outside surface of one or both ovaries; or (2) the capsule (outer covering) of the tumor has ruptured (broken open); or (3) tumor cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen).

The tumor is found in one or both ovaries and has spread into other areas of the pelvis. Stage II is divided into stage IIA, IIB, and IIC. In stage IIA, the tumor has spread to the uterus and/or the fallopian tubes (the long, slender tubes through which eggs pass from the ovaries to the uterus). In stage IIB, the tumor has spread to other tissue within the pelvis. In stage IIC, (1) the tumor has spread to the uterus and/or the fallopian tubes and/or other tissue within the pelvis; and (2) tumor cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen).

The tumor is found in one or both ovaries and has spread to other parts of the abdomen. Stage III is divided into stage IIIA, stage IIIB, and stage IIIC. In stage IIIA, the tumor is found only in the pelvis, but tumor cells have spread to the surface of the peritoneum (tissue that lines the abdominal wall and covers most of the organs in the abdomen). In stage IIIB, the tumor has spread to the peritoneum but is 2 centimeters or smaller in diameter. In stage IIIC, the tumor has spread to the peritoneum and is larger than 2 centimeters in diameter and/or has spread to lymph nodes in the abdomen. The spread of tumor cells to the surface of the liver is considered stage III disease.

The tumor is found in one or both ovaries and has metastasized (spread) beyond the abdomen to other parts of the body. The spread of tumor cells to tissues in the liver is considered stage IV disease.

Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called standard of care or best practice.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

Treatment with anticancer drugs that travel through the blood to cells all over the body.

A group or layer of cells that work together to perform a specific function.

Surgery to remove the entire uterus, including the cervix. Also called complete hysterectomy.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

Surgery to remove the ovary and fallopian tube on one side of the body.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the womb.

The muscular canal extending from the uterus to the exterior of the body. Also called birth canal.

Having to do with the vagina (the birth canal).