Borderline Ovarian Tumors: Recurrence Patterns and Management

Abstract

Purpose: We aimed to evaluate the factors associated with disease recurrence, recurrence patterns, and obstetric outcomes of borderline ovarian tumors. The main outcome was prognostic factors for disease recurrence. The secondary outcomes were recurrence sites and obstetric results. Methods: This study included patients diagnosed with BOT in Başkent University. Data was obtained from patient files and hospital records. Histopathological results were re-evaluated based on the new 2020 WHO classification. Risk factors for disease recurrence were evaluated for early-stage and advanced-stage diseases. Survival was measured from the time of diagnosis. Results: A total of 142 patients were included. The median follow-up time was 100.5 months. Recurrence occurred in 24(16.9%) patients and the 5-year RFS 86.3% and no deaths were recorded. The main recurrence site of the tumor was the same ovary (12/24, 50%). In multivariate analysis, cystectomy was found as a risk factor for recurrence in the early stage (HR:4.28; 95%CI: 1.40 – 13.08, p:0.011). One patient’s tumor showed malignant transformation (1/24, 4.17%). The pregnancy rate was 76.7% among 43 patients who attempted to conceive. There was no difference in obstetric outcomes between USO and cystectomy (p:0.223). Conclusion: The risk of recurrence in patients with BOT was higher in patients who underwent cystectomy and obstetric outcomes were similar between cystectomy and USO. In this study, most recurrences occurred in the ovaries. Therefore, fertility-sparing appears to be an appropriate choice for young women with satisfactory obstetric outcomes even in the advanced stage.