Clinicopathologic Characteristics and Reproductive Outcomes of Patients with Borderline Ovarian Tumors (BOTs): A Single Institute Experience and A Review of the Literature

Abstract

OBLECTIVES: In borderline ovarian tumor (BOT) cases, evaluating the therapy forms, the percentage of recurrence and survival and the condition of fertility after conservative surgery, for those with a fertility wish.
STUDY DESIGN: The files, follow-up forms and pathological reports of 96 cases, diagnosed with BOT, at our clinic, treated between 1994-2009, have been retrospectively evaluated.
RESULTS: The mean age of the evaluated cases was 39.54±13.4. On the basis of histopathological data, 46 cases (47.9%) had serous and 41 cases (42.7%) had mucinous, and 9 cases (9.4%) had other histological subtypes. 88 cases were in stage I, 2 cases (2.1%) were in stage II and 6 cases (6.2%) were in stage III. 89 (92.7%) cases were operated with laparatomy, 7 (7.3%) cases were operated with
laparoscopy. In 52 cases (54.1%), conservative (fertility preserving) surgery was applied (27 cases USO, 8 cases cystectomy, 17 cases USO-staging), in 44 cases (45.8%) radical surgery (in 32 cases, complete staging, TAH-BSO in 11 cases, TAH-USO in 1 case). 26% of the cases (25 cases) underwent postoperative adjuvant chemotherapy. In 39 cases with fertility wish, 8 pregnancy occured after therapy.
In the follow-up, 10 cases (10.4%) had recurrence. The rate of recurrence was 4% (2/44) after radical surgery and 15% (8/52) after conservative surgery. The general disease-free survival rate of the cases (DFS) was 89.6%, and there was no significant difference between radical and conservative surgery in view of DFS (95.45% vs 84.62%, p=0.97).
CONCLUSION: In cases of borderline ovarian tumor, the best therapy is surgical debulking and the post-operative recurrence rate is generally low. Although the recurrence risk in patients who underwent conservative surgery is relatively higher, disease free survival rates are no different than those who had radical surgery.