Oncologic and obstetric outcomes of conservative surgery for borderline ovarian tumors in women of reproductive age

Lee, Se Yun; Choi, Min Chul; Kwon, Bo Ram; Jung, Sang Geun; Park, Hyun; Joo, Won Duk; Lee, Chan; Lee, Je Ho; Lee, Joon Mo

doi:10.5468/ogs.2017.60.3.289

Cited by 13 publications

(8 citation statements)

References 30 publications

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“…Recently, Lee et al compared two subtypes of fertility sparing surgery for borderline ovarian tumors and found they had a high rate of pregnancy after surgery where 79.2 and 87.5% respectively of the patients were able to conceive and most carried to term. 13 Similar results were published by Song in 2011 and Park in 2009 with fertility rates upwards of 70% but in 2011 Kanat Pektas had a rate of only 52%. [14][15][16] A meta analysis by Vasconcelos in 2015 revealed an overall rate of approximately 50-60% and was consistent with a previous meta analysis done by Darais in 2011.…”

Section: Discussionsupporting

confidence: 77%

Laparoendoscopic single-site oophorectomy for a right ovarian borderline serous tumor of stage IC2, a literature review

Rezai¹,

Àlex²,

Hughes³

et al. 2018

OGIJ

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Background: Ovarian cancer represents approximately 30% of all female reproductive organ cancers and is the leading cause of death for gynecological cancer in the United States. Borderline ovarian tumors comprise approximately 15-20% of all epithelial ovarian tumors and within that group, serous borderline ovarian tumors comprise 53%. Serous borderline tumors (SBT) display atypical epithelial proliferation of serous type cells, outnumbering benign epithelial cells but have a low malignancy potential (borderline). By definition SBT has no gross stromal invasion but it can be subcategorized to those with or without microinvasion. Carcinomas make up 90% of ovarian tumors and differentiating between the distinct types of tumors via unique features is important for treatment. Case:The patient was a 29-year-old G0P0, who presented to our clinic for evaluation of intermenstrual bleeding. Upon physical exam, a palpable, 5cm x 4cm non-tender, mobile mass in the right adnexa was noted. Pelvic ultrasound revealed a 4.9cm x 3.7cm hypoechoic mass in the right adnexa. The mass was noted to be heterogeneous with smooth borders and a preliminary diagnosis of ovarian cystadenoma was made. The patient in this case presented with a stage 1C2 ovarian cancer and was treated with single incision laparoscopic surgery (SILS) right salpingo-oophorectomy. Conclusion:Ovarian cancer is the leading cause of gynecological cancers in women in the US and early diagnosis/staging is important in predicting progression-free survival. Instead of laparotomy, we utilized single-incision laparoscopic surgery to drain the patient's pelvic effusion and excise the right ovary and fallopian tube, which revealed an ovarian borderline serous tumor. This technique was conservative and fertility-sparing because it left the uterus, left ovary and left fallopian tube.

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Section: Discussionsupporting

confidence: 77%

Laparoendoscopic single-site oophorectomy for a right ovarian borderline serous tumor of stage IC2, a literature review

Rezai¹,

Àlex²,

Hughes³

et al. 2018

OGIJ

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“…Zhao [20] reported a total pregnant rate of 33.8%. Lee also reported that 26 of the 32 patients (81.3%) had successful pregnancies [16]. A systematic review of 230 articles on conservative management of BOTs reported the pregnancy rates ranged from 32-88%, and the pooled estimate for spontaneous pregnancies was 54% (95% CI: 38-70%, I 2 = 91%) [21] .…”

Section: Discussionmentioning

confidence: 98%

“…A large cohort study on BOT of the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO ROBOT study) con rmed ISS as an independent negative prognostic factor for disease recurrence, apart from other factors such as higher IFGO stage, residual tumour, and fertility preservation [15] . Generally, fertility preservation for BOT patients carries a good prognosis [16][17][18][19] . But few studies have discussed the safety and necessity of CSS for BOTs in FSS.…”

Section: Discussionmentioning

confidence: 99%

Oncologic and obstetric outcomes of fertility-sparing surgery for borderline ovarian tumors in women of reproductive age: a retrospective cohort study

Sun

Luo

Jiang

et al. 2020

Preprint

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Abstract Objective To retrospectively evaluate the oncologic and obstetric outcomes of fertility-sparing surgery (FSS) for borderline ovarian tumors(BOT). Methods 132 patients with borderline ovarian tumors were divided into the incompletely staging surgery (ISS) group and the completely staging surgery (CSS) group. The overall survival and disease-free survival curves were determined using the Kaplan–Meier method. The Cox proportional hazards method was used to assess the association between the variables and live birth and multivariate analysis to identify the independent associations. Results Chi-square and Kaplan-Meier analyses showed no significant differences in overall survival between the two groups (p = 1.000 and p = 0.716, respectively). The CSS group had fewer relapses and longer disease-free survival than ISS (p = 0.003). There was no statistical difference in live birth rate between two groups (crude odds ratio = 0.885, 95%CI 0.411–1.903, p = 0.755; adjusted odds ratio = 0.848, 95%CI 0.366–1.963, p = 0.700). Age was the only independent risk factor for live birth (adjusted odds ratio = 0.902, 95%CI 0.823–0.988, p = 0.027). Mean live birth intervals after FSS was 31.86 ± 19.325 months. Conclusions CSS significantly increased the disease-free survival time of BOT and reduced the relapse risk. However, CSS had a slightly negative and statistically insignificant association with live birth.

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“…Sixteen studies compared the risk of BOT recurrence between patients underwent unilateral salpingooophorectomy and unilateral/bilateral cystectomy (Table 2) [12,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32], and the results of the pooled analysis revealed that the rate of tumor relapse was significantly higher in patients receiving unilateral/bilateral cystectomy (OR=2.02, 95% CI: 1.59-2.57, P < 0.001, Fig. 1).…”

Section: Comparison Of Postoperative Recurrence Risk Between Patients With Unilateral Salpingo-oophorectomy and Unilateral/bilateral Cystmentioning

confidence: 99%

Salpingo-oophorectomy versus cystectomy in patients with borderline ovarian tumors: a systemic review and meta-analysis on postoperative recurrence and fertility

Wang

Fang

2021

World J Surg Onc

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Background To compare the postoperative recurrence and fertility in patients with borderline ovarian tumors (BOTs) who underwent different surgical procedures: salpingo-oophorectomy versus cystectomy. Methods Potentially relevant literature from inception to Nov. 06, 2020, were retrieved in databases including Cochrane Library, EMBASE (Ovid), and MEDLINE (Pubmed). We applied the keywords “fertility-sparing surgery,” or “conservative surgery,” or “cystectomy,” or “salpingo-oophorectomy,” or “oophorectomy,” or “adnexectomy,” or “borderline ovarian tumor” for literate searching. Systemic reviews and meta-analyses were performed on the postoperative recurrence rates and pregnancy rates between patients receiving the two different surgical methods. Begger’s methods, Egger’s methods, and funnel plot were used to evaluate the publication bias. Result Among the sixteen eligible studies, the risk of recurrence was evaluated in all studies, and eight studies assessed the postoperative pregnancy rates in the BOT patients. A total of 1839 cases with borderline ovarian tumors were included, in which 697 patients (37.9%) received unilateral salpingo-oophorectomy and 1142 patients (62.1%) underwent unilateral/bilateral cystectomy. Meta-analyses showed that BOT patients with unilateral/bilateral cystectomy had significantly higher recurrence risk (OR=2.02, 95% CI: 1.59-2.57) compared with those receiving unilateral salpingo-oophorectomy. Pooled analysis of four studies further confirmed the higher risk of recurrence in patients with cystectomy (HR=2.00, 95% CI: 1.11-3.58). In addition, no significant difference in postoperative pregnancy rate was found between patients with the two different surgical procedures (OR=0.92, 95% CI: 0.60-1.42). Conclusion Compared with the unilateral/bilateral cystectomy, the unilateral salpingo-oophorectomy significantly reduces the risk of postoperative recurrence in patients with BOT, and it does not reduce the pregnancy of patients after surgery. Trial registration PROSPERO CRD42021238177

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Oncologic and obstetric outcomes of conservative surgery for borderline ovarian tumors in women of reproductive age

Cited by 13 publications

References 30 publications

Laparoendoscopic single-site oophorectomy for a right ovarian borderline serous tumor of stage IC2, a literature review

Laparoendoscopic single-site oophorectomy for a right ovarian borderline serous tumor of stage IC2, a literature review

Oncologic and obstetric outcomes of fertility-sparing surgery for borderline ovarian tumors in women of reproductive age: a retrospective cohort study

Salpingo-oophorectomy versus cystectomy in patients with borderline ovarian tumors: a systemic review and meta-analysis on postoperative recurrence and fertility

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