Borderline ovarian tumours-patterns of recurrence and fertility outcome

Abstract

Background: The aim of the study was to evaluate the factors affecting recurrence and prognosis in patients with borderline ovarian tumours and to assess the fertility outcome in women treated with conservative surgery.Methods: Fifty-six patients diagnosed with borderline ovarian tumours during the period between January 2005 and December 2009 in Regional Cancer Centre (RCC), Thiruvananthapuram were included. Patients were followed till December 2012.Results: Median follow up period was 52.5 months. The mean age at diagnosis was 33.5 yrs. Histopathology was serous in 41.1%, mucinous in 57.1%, and endometrioid in 1.8%. 48 patients (85.7%) had stage I disease, 2 patients (3.6%) had Stage II disease and 6 patients (10.7%) had stage III disease at diagnosis. 11 patients (19.6%) had bilateral tumours of which 7(63.6%) were serous and 4 were mucinous. 27 patients (48.2%) underwent fertility sparing surgery of which 13 patients underwent cystectomy and 14 underwent ovariotomy. 29 patients (51.78 %) underwent complete surgery including hysterectomy, bilateral salpingo oopherectomy and omentectomy. 14.3% of patients had microinvasive disease and 14.3 % had micro papillary disease on histopathology. 9 patients (16.1 %) had peritoneal implants of which 1 was invasive and 8 were non-invasive. Recurrence rate in the entire study group was 30.4%, 14.28% among patients undergoing complete surgery, 28.57% among patients undergoing adnexectomy and 69.2% among patients undergoing cystectomy.Conclusions: Univariate analysis showed a significant association between micropapillary histology, peritoneal implants and recurrence. On multivariate analysis, only peritoneal implants were found to be independently associated with recurrence.