abstract: The effect of hysterectomy on survival of patients with borderline ovarian tumors (repost)

The effect of hysterectomy on survival of patients with borderline ovarian tumor

Objective
The classically recommended surgical treatment of borderline ovarian tumors (BOTs) includes hysterectomy in addition to bilateral adnexectomy. Possible reasons for hysterectomy might be a high frequency of uterine involvement and its favorable effect on survival. The purpose of the present study was to assess the frequency of uterine involvement in patients with BOTs and the effect of hysterectomy on survival.

Methods
All incident cases of histological confirmed BOTs diagnosed in Israeli Jewish women between March 1 1994 and June 30 1999, were identified. Clinical and pathological characteristics were abstracted from medical records. Patients with tumors grossly confined to the ovaries (apparently stage I) were considered to have had surgical staging when at least hysterectomy, bilateral salpingooophorectomy, omentectomy and pelvic lymph node sampling were done.

Results 
The study group comprised 225 patients. Hysterectomy was performed in 147 (65.31%) patients and uterine involvement was present in only 3 (2.0%) of them. The 13 year survival of the total group of patients was 85.8% and of those in apparent stage I, 88.5%. Among patients with tumors apparently confined to the ovaries, no significant survival difference was observed between unstaged and surgically staged patients. There was also no survival difference between the overall staged and unstaged patients and between patients in stages II–III who did and did not undergo hysterectomy.

Conclusions 
Our data indicate that the rate of uterine involvement in BOT is low and that hysterectomy does not favorably affect survival. The necessity of hysterectomy in BOT patients is questioned.

Lynch Syndrome Hereditary Cancers Public Awareness Day | Fight Colorectal Cancer

Increased Risk of Cancer

If a parent carries a Lynch mutation there is a 50-50 chance that their child will inherit Lynch syndrome with

• 60 to 80 percent increased lifetime risk of colorectal cancer.
• 40 to 70 percent increased risk of endometrial cancer (cancer of the uterus lining).
• 13 percent increased risk for stomach cancer
• 12 percent increased risk of ovarian cancer.
• smaller, but significant risk of small intestine, urinary tract, heptobiliary (liver, gall bladder and bile ducts), skin, and brain cancers.
• Some families may also have increased risk for breast cancer.

Note: 
Lynch Syndrome is also noted for multiple primary cancers (different cancers in one person)

Endometroid adenocarcinoma of the uterus, borderline tumor of the ovary and Brenner tumor of the contralateral ovary (case report)

Definition: Brenner tumours are uncommon tumours that are part of the surface epithelial-stromal tumour group of ovarian neoplasms

Caveats and Concerns With New Study on Hormone Therapy and Breast Cancer

Note: references studies - WHI (Women's Health Initiative) and California Teachers Study

Clinicians vary in their approaches to HT, said Dr. Ursin. "Certain gynecologists are very careful with finding the right dose for each woman, and some even prescribe [estrogen] alone for women who have a uterus, but then monitor the uterus carefully. Please keep in mind that the risk of breast cancer associated with EPT is relatively moderate. The risk of endometrial cancer with [estrogen] alone is much higher — a more than 4-fold increase in risk in this same population of California teachers," she said.

Marjie - The support of 'family'

"...Margie is in the midst of a battle with colon, ovarian, and uterus cancer, and Saturday was her first time attending...."

The origin of serous ovarian cancer may be found in the uterus: A novel hypothesis

Study Finds Breast Cancer Metastasis Increases After Estrogen And Progestin Hormone Therapies

Note: a second study published in Menopause/postmenopausal women/preclinical study

"Although Hyder said that the study was independent of whether or not the ovaries were intact, it's still unclear whether progestins have the same effects in pre-menopausal women.

"Especially if there's a family history of breast cancer, it's advisable not to take progestins. It's a difficult call that must be made on an individual basis by a physician," Hyder said...."