Borderline ovarian tumors, optimization of diagnostic and treatment methods: 321.20 – Oncology and radiotherapy: Summary of PhD thesis in medical sciences

Abstract

Thesis structure. The work comprises 129 pages of text, and is organized as follows: introduction, 4 chapters, general conclusions, practical recommendations, and a bibliography index with 180 references. The illustrative material includes 33 figures, 2 tables, 1 statistical formula, and 4 annexes. Additionally, the thesis topic has been the subject of 32 scientific papers, including 4 solo-authored articles and 23 articles in peer-reviewed journals. Keywords: borderline ovarian tumor, radical surgical treatment, conservative surgical treatment, chemotherapy treatment, invasive implants, non-invasive implants, prognosis, recurrence, survival. Field of study: Medicine - oncology and radiotherapy. The Purpose of the Study: is to optimize the methods of diagnosis and treatment (surgical and chemotherapeutic) of patients with borderline ovarian tumors (BOT) according to age and clinical-morphological factors to improve the quality of life. Research objectives: to achieve the goal, the following research objectives were stipulated: 1) clinical, paraclinical study and macroscopic intraoperative assessment of BOT; 2) studying morphological, immunohistochemical criteria in differentiating BOT from benign ovarian tumors and ovarian cancer; 3) assessment of the indications for conservative and radical surgical treatment according to the age of the patient and the stage of the tumor process; 4) assessment of chemotherapy treatment indications according to the stage of the tumor process; 5) developing the diagnosis and treatment algorithm of BOT. The scientific novelty and originality of the work. The indications and contraindications for radical or conservative surgical interventions (with preservation of reproductive function) were determined according to the morphological subtype in patients with BOT according to the morphological subtype, the indications and contraindications for the administration of chemotherapeutic treatment with the aim of preventing recurrences and metastases and to prolongation of survival in patients in advanced stages. Based on the risk factors, the advantages and disadvantages of different surgical or combined treatment methods (surgical + chemotherapy) in the reproductive, premenopause and menopause periods were specified, a fact that contributed to the consolidation of surgical treatment methods and allowed the preservation of the functions of reproduction, and for patients in advanced stages – increased survival. The significant scientific problem addressed. In the paper consists in the optimization of diagnostic and treatment methods (surgical and chemotherapeutic) in patients with BOT. The theoretical significance of the work. Work consists in perfecting the management methods of patients with BOT, the volume of surgical intervention depending on age, the administration of chemotherapy treatment according to the stage and the morphological result, the advantages and disadvantages, the indications and contraindications, as well as the survival rate depending on the treatment applied. The practical value of the work. The results of the study were the basis for the development of practical recommendations in the conduct of gynecologists and oncologists to optimize diagnosis, surgical and chemotherapeutic treatment, with the development of a diagnostic and treatment algorithm, which makes it possible to personalize the conduct of patients with BOT. Implementation of the Scientific Findings. The results of the study were implemented in the didactic process of the Department of Oncology of IP USMF Nicolae Testemițanu for students, residents and doctors within the Continuing Medical Education, as well as in the current curative activity of the Oncological Institute.