Borderline ovarian tumor in pregnancy: can surgery wait? A case series

Urbinati, Ailyn Mariela Vidal; Iacobone, Anna Daniela; Pace, Raffaela C. Di; Pino, Ida; Pittelli, Maria Rosa; Guerrieri, Maria Elena; Preti, Eleonora Petra; Franchi, D.

doi:10.1007/s00404-021-06080-0

Cited by 9 publications

(8 citation statements)

References 40 publications

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“…Zilliox, M. et al have shown the feasibility of treating BOTs surgically during pregnancy [ 10 ]. Study has also demonstrated that "expectant treatment" could be a safe choice for recurrent BOTs found in pregnancy [ 11 ]. Two patients in our study were pregnant at the time of the second recurrence, and they underwent laparoscopic operation under general anesthesia at mid-pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Second fertility-sparing surgery and fertility-outcomes in patients with recurrent borderline ovarian tumors

Wang

Zhong

et al. 2022

Arch Gynecol Obstet

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Background At the time of recurrence, many borderline ovarian tumor (BOT) patients are still young with fertility needs. The purpose of this study is to evaluate the reproductive outcomes and recurrence rate of second fertility-sparing surgery (FSS) in women with recurrent BOTs. Methods Seventy-eight women of childbearing age diagnosed with recurrent BOTs from November 2009 to 2020 whose primary treatment was FSS were included. Results The FIGO stage I disease accounted for 46.2% and serous BOT accounted for 87.2% in the study group. Forty-seven patients underwent second FSS, and the remaining 31 underwent radical surgery (RS). Seventeen patients relapsed again after second surgery, but no malignant transformation and tumor-associated deaths were reported. Compared to FIGO stage I, the FIGO stage III tumors were more likely to relapse, but there was no statistical difference in pregnancy rate among patients with different stages. In the second FSS group, recurrence rate was higher in patients who underwent oophorocystectomy compared to patients with unilateral salpingo-oophorectomy (USO), but the pregnancy rate was similar. There was no significant difference in postoperative recurrence risk between USO and RS. The recurrence rate was not associated with operative route (laparoscopy or laparotomy), or lymphadenectomy, or postoperative chemotherapy. Among the 32 patients who tried to conceive, the pregnancy rate was 46.9% and live birth rate was 81.3%. Conclusion Unilateral salpingo-oophorectomy is a safe procedure for FIGO stage I recurrent BOT patients with fertility needs, and can achieve a high postoperative pregnancy rate and live birth rate.

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Section: Discussionmentioning

confidence: 99%

Second fertility-sparing surgery and fertility-outcomes in patients with recurrent borderline ovarian tumors

Wang

Zhong

et al. 2022

Arch Gynecol Obstet

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“…Therefore, preserving fertility is an important consideration in the choice of treatment scheme ( 10 ). However, compared with radical surgery, fertility-preserving surgery has a higher recurrence rate ( 1 ), which is comprehensively estimated by a systematic review report to be 13%, while the recurrence rate after radical surgery is 0–5%, but most recurrences show no malignant change ( 11 ). Among the 17 patients in this paper, 3 patients with malignancy suggested by postoperative paraffin pathology underwent comprehensive staged surgery again, and the rest underwent fertility-preserving surgery.…”

Section: Discussionmentioning

confidence: 99%

“…An ovarian tumor is a common tumor of the female reproductive system. With the extension of the reproductive age of women and the popularization and deepening of perinatal health care, the incidence and detection rate of pregnancy with ovarian tumors are also gradually increasing ( 1 ). Most ovarian tumors during pregnancy are physiological cysts or benign tumors, and less malignant or borderline tumors.…”

Section: Introductionmentioning

confidence: 99%

Clinical Analysis of 17 Cases of Borderline Ovarian Tumors During Pregnancy

Wang

et al. 2022

Front. Oncol.

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ObjectiveThe study retrospectively analyzed the clinical characteristics and prognosis of 17 cases of pregnancy complicated by borderline ovarian tumors to provide help for clinical workers.Materials and MethodsThe clinicopathological data of 17 patients with ovarian borderline tumors during pregnancy at the Shengjing Hospital of China Medical University from January 2015 to June 2021 were collected and analyzed retrospectively. The average age of the patients was 31.82 years (25–45 years), the average number of pregnancies was 2.06 times (1–6 times), and the average number of births was 0.41 times (0–1 time).ResultsAmong the 17 patients, 4 were diagnosed in the first trimester, 2 in the second trimester, and 11 in the third trimester. Most of the first symptoms were cysts, cyst enlargement, or cyst rupture. Among them, 3 cases (1 in the first trimester and 2 in the second trimester) continued pregnancy after a conservative operation, 9 cases underwent cesarean section and a conservative operation simultaneously, and the mother and child had a good outcome. Two cases underwent conservative operations and induced abortion, and 1 case underwent an ectopic pregnancy operation at the same time. The prognosis of the patients was good without recurrence.ConclusionPreoperative diagnosis of borderline ovarian tumors in pregnancy is delayed, and imaging and tumor markers are not specific. The coincidence rate between intraoperative frozen pathology and postoperative paraffin pathology was not high. Borderline tumors are mainly treated by surgery, and the prognosis for mothers and infants is good.

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“…A high live birth rate (91.6%) was found and only two pregnancies ended with spontaneous miscarriages. None of the patients developed an invasive recurrence later in life [1].…”

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confidence: 87%