HOPKINS-BACKED TREATMENT PLAN FOR OVARIAN TUMORS ADOPTED A new approach to the treatment of early or stage I ovarian tumors less likely to become cancerous may spare young women the loss of an ovary and protect patients' chances of becoming pregnant. Under the plan, recommended by Hopkins gynecologic pathologist Cornelia L. Trimble, surgeons would remove only the tumor, sparing the other ovary and sustaining fertility. Traditionally, such tumors are treated aggressively with removal of both ovaries and the uterus, in addition to chemotherapy or radiation; doctors assumed the tumors would develop into ovarian cancer. But during the April National Institutes of Health Consensus Conference in Bethesda, Md., Dr. Trimble proposed that patients with tumors of low malignant potential, or TLMP, be treated more conservatively. Experts at the conference agreed. In a study of 953 TLMP patients, published in the International Journal of Gynecological Pathology in 1993, Dr. Trimble and fellow Hopkins gynecologic pathologist Robert J. Kurman reported a 99 percent survival rate after five years among patients who had a tumor confined to only the ovary and a five-year survival rate of 92 percent among women with advanced TLMP. "In our opinion, these tumors should be viewed as benign tumors, in the same light as we view fibroids," Dr. Kurman said. "The risk of developing cancer in a TLMP is similar to that of developing cancer in a fibroid, but we don't recommend aggressive cancer therapy for fibroids." For younger women, conservative treatment means retaining the possibility of pregnancy. Studies suggest that pregnancy is safe after conservative treatment of the tumors, Dr. Trimble said. "The studies imply that women who have had TLMP and become pregnant do not have an additional risk of developing ovarian cancer," Dr. Trimble said.
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