Question asked by: 
Anonymous
Date asked: 
Mar 2015

What is the recommended follow up for a borderline tumour (stage 1c)? Is CA125 monitoring necessary after surgery if treatment included a total hysterectomy and removal of both ovaries? Due to completion surgery, I understand a chance of recurrence is very low, but are there still any risks involved if the tumour ruptured before surgery?

What is the recommended follow-up for a borderline tumour (stage 1c)?
The risk of recurrence for a borderline tumour is always much lower than for an invasive cancer but is slightly higher if there was rupture of the cyst or tumour before surgery.
Response by Professor Richard Edmondson, Professor of Gynaecological Oncology

The risk of recurrence for a borderline tumour is always much lower than for an invasive cancer but is slightly higher if there was rupture of the cyst or tumour before surgery. The risk decreases with time so the longer it has been since the time of surgery the less likely it is that it will come back but there is always a small risk.

CA125 can be a useful marker but is probably only any use if it was elevated at the time that the tumour was first diagnosed. Not all borderline tumours produce a rise in CA125 and so if it wasn't elevated when the first tumour was there it is unlikely to rise if the tumour comes back. If it was raised initially however then it may be a useful marker.

The role of follow up for these tumours is controversial and there are lots of different opinions. Choosing what is right for you will depend on the details of your particular tumour (some are more likely to recur than others), what surgery has already been done and your own views (as well as those of your doctor). If this sounds a little vague then it reflects what many of us are trying to develop in terms of follow up that is individualised to your own particular case.