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Gynecol Oncol. 2009 Apr;113(1):75-82. doi: 10.1016/j.ygyno.2008.12.034. Epub 2009 Jan 25.

Surgical management of borderline ovarian tumors: The role of fertility-sparing surgery.

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  • 1Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, #388-1 Poongnap-2 dong, Songpa-gu, Seoul, 138-736, Republic of Korea.

Abstract

OBJECTIVE:

To evaluate the recurrence, survival, and pregnancy outcomes of patients with borderline ovarian tumors (BOT) treated with fertility-sparing surgery.

METHODS:

The medical records of patients with BOT who underwent surgery between 1989 and 2008 were retrospectively reviewed. Outcomes were compared between groups that underwent radical or fertility-sparing surgery. Fertility-sparing surgery was defined as the preservation of the uterus and ovarian tissue in one or both adnexa.

RESULTS:

During the study period, 360 patients with BOT were identified; of these, 344 had stage I, one had stage II, and 15 had stage III disease. A total of 176 patients underwent radical surgery (23 laparoscopically and 153 laparotomically), and 184 underwent fertility-sparing surgery (48 laparoscopically and 136 laparotomically). After surgery, 45 patients received adjuvant chemotherapy. After a median follow-up time of 70 months (range, 3-216 months), 18 patients had recurrent disease and 5 died of disease. The recurrence rate was similar in the radical and fertility-sparing surgery groups (4.9% vs. 5.1%, p=0.923). In the fertility-sparing surgery group, however, the most common site of recurrence was the remaining ovarian tissue which was successfully salvaged with a second round of fertility-sparing surgery. Multivariate analysis showed no difference in disease-free survival between groups that underwent radical or fertility-sparing surgery (p=0.651). To date, there have been 34 full-term deliveries by women in the fertility-sparing surgery group.

CONCLUSIONS:

Fertility-sparing surgery for patients with BOT is safe and can permit future pregnancy, suggesting that such surgery should be considered for young patients who wish to preserve fertility.

[PubMed - indexed for MEDLINE]
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