Staging procedures fail to benefit women with borderline ovarian tumours who want to preserve fertility: a retrospective analysis of 448 cases

Abstract

Background: To evaluate the effect of clinicopathologic factors on the prognosis and fertility outcomes of BOT patients. Methods: We performed a retrospective analysis of BOT patients who underwent surgical procedures in West China Second University Hospital from 2008 to 2015. The DFS outcomes, potential prognostic factors and fertility outcomes were evaluated. Results: Four hundred forty-eight patients were included; 52 recurrences were observed. Ninety-two patients undergoing FSS achieved pregnancy. No significant differences in fertility outcomes were found between the staging and unstaged surgery groups. Staging surgery was not an independent prognostic factor for DFS. Laparoscopy resulted in better prognosis than laparotomy in patients with stage I tumours and a desire for fertility preservation. Conclusion: Patients with BOT fail to benefit from surgical staging. Laparoscopy is recommended for patients with stage I disease who desire to preserve fertility. Physicians should pay more attention to risk of recurrence in patients who want to preserve fertility.

PAX2, PAX8, and PR are correlated with ovarian seromucinous borderline tumor with endometriosis

“…The median age of SMBT in this study was slightly younger than in other literatures, which showed more late reproductive ages as 45–47 years [ 5 , 6 ] or even 63.2 years [ 7 ]. However, these studies had relatively smaller number of cases than the present study, and large cohort of ovarian borderline tumor reported that the mean age was 36–38 years [ 8 ], similar to this study.…”

Evaluation of Clinicopathologic Factors and Surgery Management on Borderline Ovarian Tumor Outcomes

“…Considering the type of surgery, Morrison, Plett et al, and Li et al believed in the importance of surgery types in recurrence (2,16,17,24). In FSS, unilateral cystectomy, whether done by laparoscopy or laparotomy, is mentioned as a risk factor for recurrence (15,22).…”

“…According to the oncological outcomes at the last follow-up, performing laparoscopy was not significantly associated with a higher recurrence rate; however, the recurrence interval was shorter in comparison to laparotomy. Li et al presented unilateral salpingooophorectomy, as an alternative surgery, with emphasis on laparoscopy being introduced as the preferred technique in stage I (24). It is noticeable that there are a few reports of trocar metastases in patients, for whom laparoscopy was performed besides to higher rate of recurrence and lack of accuracy in staging mentioned by some authors (4,14).…”

“…As another controversy on the surgery technique, it is recommended that staging should be performed during BOT surgeries by omental and peritoneal biopsies and routine lymphadenectomy should be avoided since even lymph node involvement may not alter the survival and recurrence rate of the disease (7,14,27); however, some authors do not agree with the benefits of staging (24). Yilmaz et al presented involvement of lymph nodes in 25% of cases with a lack of effect on survival, which is in contrast to previous studies (4,14).…”