The safety of fertility and ipsilateral ovary procedures for borderline ovarian tumors

// Tong Lou 1, * , Fang Yuan 2, * , Ying Feng 1 , Shuzhen Wang 1 , Huimin Bai 1 and Zhenyu Zhang 1 1 Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China 2 Department of Obstetrics and Gynecology, the affiliated hospital of Qingdao University, Qingdao, China * These authors contributed equally to this work Correspondence to: Huimin Bai, email: baihuimin2017@163.com Zhenyu Zhang, email: zhangzhenyuzzy2016@163.com Keywords: borderline ovarian tumor; BOT; recurrence; survival; treatment Received: September 04, 2017 Accepted: November 17, 2017 Published: December 06, 2017 ABSTRACT Objective: To explore the optimal treatment options for women with borderline ovarian tumors (BOTs). Materials and Methods: The medical records of consecutive patients with BOTs in two academic institutions were retrospectively collected. The pertinent data, including clinicopathological characteristics and, treatment and prognostic information were evaluated. Results: A total of 281 cases of BOTs were included in this analysis. For the entire series, the 5- year disease-free survival (DFS) and overall survival (OS) rates were 91.8% and 98.5%, respectively. In the multivariate analysis, reservation of the ipsilateral ovary (HR: 0.104 [95% CI, 0.036–0.304], p = 0.000) and FIGO stage II–III (HR: 6.811 [95% CI, 2.700–17.181], p = 0.000) were the independent risk factors for recurrence. Ovarian surface involvement (HR: 64.996 [95% CI, 4.054–1041.941], p = 0.003) was the only independent prognostic factor for OS. Lymphadenectomy and adjunct chemotherapy had no significant impact on patients’ recurrence and survival (recurrence: p = 0.332 and 0.290, respectively, survival: p = 0.896 and 0.216, respectively). Conclusions: Fertility-sparing surgery with healthy ovarian preservation seems safe and feasible for young women who prefer fertility-sparing treatment. Ovarian cystectomy to conserve the affected ovary/ovaries without ovarian surface involvement may be cautiously performed under fully informed consent for young women with bilateral BOTs who strongly prefer fertility-sparing treatment and have no evidence of infertility. However, long-term follow-up is necessary due to the relapse susceptibility of the ovary.