Authors
Department Gynecology Oncology, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective factors on recurrence and fertility rate.
Methods: In this cohort study, the required information was collected from a file of 43 patients with final pathologic diagnosis of borderline ovarian tumor, who had undertaken fertility sparing surgery at Imam Khomeini Hospital, Tehran University of Medical Sciences, and recurrence rate, fertility rate, and the effect of different variables were studied.
Results: There were significant correlations between oral contraceptive pill (OCP) consumption, serous pathology, micro invasion in pathology, advanced stages, and recurrence rate of BOT, while this relationship was not found between parity, surgical methods (laparotomy and laparoscopy), surgical techniques (cystectomy and USO), papillary projection, and recurrence rate.
Conclusions: Although the recurrence rate was higher in the current research when compared to other previous studies, yet only in one patient, the pattern of recurrence was invasive epithelial carcinoma, thus in the current study the overall survival did not seem to change. The results of this study on fertility rate are comparable to other studies on this issue. Therefore, these methods are recommended for young patients and emphasis should be place on follow-up.
Keywords
- Lenhard MS, Mitterer S, Kumper C, Stieber P, Mayr D, Ditsch N, et al. Long-term follow-up after ovarian borderline tumor: relapse and survival in a large patient cohort. Eur J Obstet Gynecol Reprod Biol. 2009;145(2):189-94. [DOI:10.1016/j.ejogrb.2009.04.031] [PMID]
- Trillsch F, Mahner S, Ruetzel J, Harter P, Ewald-Riegler N, Jaenicke F, et al. Clinical management of borderline ovarian tumors. Expert Rev Anticancer Ther. 2010;10(7):1115-24. [DOI:10.1586/era.10.90] [PMID]
- Jones MB. Borderline ovarian tumors: current concepts for prognostic factors and clinical management. Clin Obstet Gynecol. 2006;49(3):517-25. [DOI:10.1097/00003081-200609000-00011] [PMID]
- Lalwani N, Shanbhogue AK, Vikram R, Nagar A, Jagirdar J, Prasad SR. Current update on borderline ovarian neoplasms. AJR Am J Roentgenol. 2010;194(2):330-6. [DOI:10.2214/AJR.09.3936] [PMID]
- Fortin A, Morice P, Thoury A, Camatte S, Dhainaut C, Madelenat P. Impact of infertility drugs after treatment of borderline ovarian tumors: results of a retrospective multicenter study. Fertil Steril. 2007;87(3):591-6. [DOI:10.1016/j.fertnstert.2006.07.1503] [PMID]
- May T, Virtanen C, Sharma M, Milea A, Begley H, Rosen B, et al. Low malignant potential tumors with micropapillary features are molecularly similar to low-grade serous carcinoma of the ovary. Gynecol Oncol. 2010;117(1):9-17. [DOI:10.1016/j.ygyno.2010.01.006] [PMID]
- Trope CG, Kaern J, Davidson B. Borderline ovarian tumours. Best Pract Res Clin Obstet Gynaecol. 2012;26(3):325-36. [DOI:10.1016/j.bpobgyn.2011.12.006] [PMID]
- Morris RT, Gershenson DM, Silva EG, Follen M, Morris M, Wharton JT. Outcome and reproductive function after conservative surgery for borderline ovarian tumors. Obstet Gynecol. 2000;95(4):541-7. https://doi.org/10.1097/00006250-200004000-00012 [DOI:10.1016/S0029-7844(99)00619-5] [PMID]
- Riman T, Dickman PW, Nilsson S, Correia N, Nordlinder H, Magnusson CM, et al. Risk factors for epithelial borderline ovarian tumors: results of a Swedish case-control study. Gynecol Oncol. 2001;83(3):575-85. [DOI:10.1006/gyno.2001.6451] [PMID]
- Huusom LD, Frederiksen K, Hogdall EV, Glud E, Christensen L, Hogdall CK, et al. Association of reproductive factors, oral contraceptive use and selected lifestyle factors with the risk of ovarian borderline tumors: a Danish case-control study. Cancer Causes Control. 2006;17(6):821-9. [DOI:10.1007/s10552-006-0022-x] [PMID]
- Du Bois A, Rochon J, Lamparter C, Pfisterer J, A. G. O. Organkommission OVAR PFisterer . Pattern of care and impact of participation in clinical studies on the outcome in ovarian cancer. Int J Gynecol Cancer. 2005;15(2):183-91. https://doi.org/10.1111/j.1525-1438.2005.15202.x [DOI:10.1136/ijgc-00009577-200503000-00001] [PMID]
- Morice P. Borderline tumours of the ovary and fertility. Eur J Cancer. 2006;42(2):149-58. [DOI:10.1016/j.ejca.2005.07.029] [PMID]
- Romagnolo C, Gadducci A, Sartori E, Zola P, Maggino T. Management of borderline ovarian tumors: results of an Italian multicenter study. Gynecol Oncol. 2006;101(2):255-60. [DOI:10.1016/j.ygyno.2005.10.014] [PMID]
- Faluyi O, Mackean M, Gourley C, Bryant A, Dickinson HO. Interventions for the treatment of borderline ovarian tumours. Cochrane Database Syst Rev. 2010;(9):7696. [DOI:10.1002/14651858.CD007696.pub2] [PMID]
- Chen RF, Li J, Zhu TT, Yu HL, Lu X. Fertility-sparing surgery for young patients with borderline ovarian tumors (BOTs): single institution experience. J Ovarian Res. 2016;9:16. [DOI:10.1186/s13048-016-0226-y] [PMID]
- Uzan C, Kane A, Rey A, Gouy S, Duvillard P, Morice P. Outcomes after conservative treatment of advanced-stage serous borderline tumors of the ovary. Ann Oncol. 2010;21(1):55-60. [DOI:10.1093/annonc/mdp267] [PMID]
- Morice P, Uzan C, Fauvet R, Gouy S, Duvillard P, Darai E. Borderline ovarian tumour, pathological diagnostic dilemma and risk factors for invasive or lethal recurrence. Lancet Oncol. 2012;13(3):103-15. [DOI:10.1016/S1470-2045(11)70288-1]
- Seong SJ, Kim DH, Kim MK, Song T. Controversies in borderline ovarian tumors. J Gynecol Oncol. 2015;26(4):343-9. [DOI:10.3802/jgo.2015.26.4.343] [PMID]
- Shih KK, Zhou Q, Huh J, Morgan JC, Iasonos A, Aghajanian C, et al. Risk factors for recurrence of ovarian borderline tumors. Gynecol Oncol. 2011;120(3):480-4. [DOI:10.1016/j.ygyno.2010.11.016] [PMID]
- Koskas M, Uzan C, Gouy S, Pautier P, Lhomme C, Haie Meder C, et al. Fertility determinants after conservative surgery for mucinous borderline tumours of the ovary, (excluding peritoneal pseudomyxoma). Hum Reprod. 2011;26(4):808-14. [DOI:10.1093/humrep/deq399] [PMID]
- Lian C, Chen X, Ni Y, Huang X, Lin Y. Pregnancy after fertilitysparing surgery for borderline ovarian tumors. Int J Gynaecol Obstet. 2016;134(3):282-5. [DOI:10.1016/j.ijgo.2016.03.018] [PMID]
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