Fertility sparing treatment in borderline ovarian tumours

Álvarez, Rosa; Vázquez-Vicente, Daniel

doi:10.3332/ecancer.2015.507

Cited by 24 publications

(18 citation statements)

References 89 publications

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“…There was no significant difference in PFS between the other methods of fertility-preserving surgery (USO and USO + CC) and radical surgery, or among the three styles of fertility-preserving surgery. This is corroborated by findings in other studies: Chen et al found that the choice of surgical methods used to preserve fertility had significant impact on recurrence and subsequent pregnancy [15]; the same is reported in other studies [16, 17]. Taken together, these results suggest that the types of fertility-preserving surgery have different impacts on oncologic and pregnancy outcomes of BOT patients.…”

Section: Discussionsupporting

confidence: 87%

Identification of factors that impact recurrence in patients with borderline ovarian tumors

et al. 2017

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BackgroundThe lack of consensus around best practices for management of borderline ovarian tumors (BOT) is, in part, to the lack of available data and of clarity in interpreting relationships among various factors that impact outcomes. The objective of this study was to identify clinicopathological factors that impact prognosis of patients with borderline ovarian tumors (BOT) and to address features of this disease with the objective of providing clarity in decision making around management of BOT.ResultsA total of 178 BOT patients were included in this study, with a median age of 43 years and a median follow-up time of 37 months. Thirty-two (18.0%) recurrences and 5 (2.8%) deaths were observed in this study group. Multivariate analysis showed that fertility-preserving surgery (P = 0.0223 for bilateral cystectomy) and invasive implants (P = 0.0030) were significantly associated with worse PFS, whereas lymphadenectomy (P = 0.0129) was related to improved PFS. No factors were found to be associated with OS due to the limited number of deaths. In addition, patients with serous BOT more commonly had abnormal levels of CA125, while patients with mucinous BOT more commonly had abnormal levels of CEA. Patients with abnormal levels of CA125, or CA19-9, or HE4 had significantly larger tumor sizes.ConclusionsOur study reveals the impact of certain types of fertility-preserving surgery, lymphadenectomy and invasive implants on PFS of BOT patients. Blood cancer markers may be associated with histology and size of BOT. Our findings may assist in selection of optimum treatment for BOT patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s13048-017-0316-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Identification of factors that impact recurrence in patients with borderline ovarian tumors

et al. 2017

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“…However, the difference in pregnancy rate among different fertility sparing surgery modalities was not statistically significant, which was in accordance with the results from previous studies. Compared with unilateral salpingo-oophorectomy, patients undergoing cystectomy had a higher pregnancy rate since more normal ovarian tissues were retained [ 27 ]. On the other hand, cystectomy may also increase the risk of recurrence and impact the DFS.…”

Section: Discussionmentioning

confidence: 99%

The impact of clinicopathologic and surgical factors on relapse and pregnancy in young patients (≤40 years old) with borderline ovarian tumors

et al. 2018

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BackgroundFertility sparing surgery has been extensively performed among patients with borderline ovarian tumors due to their age and favorable prognosis. Nevertheless, the prognosis and obstetric outcomes in these patients remain uncertain. Thus, the current study was carried out to evaluate the oncological safety and fertility benefits of different fertility sparing surgery subtypes and various clinicopathological parameters.MethodsYoung borderline ovarian tumor patients with an age of ≤40 years, who were admitted and treated in Zhejiang Cancer Hospital from January 1996 to December 2016, were enrolled in this study and reviewed retrospectively. The prognostic and obstetric effects of clinicopathological and surgical variables were evaluated using univariate/multivariate analyses and survival curves.ResultsA total of 92 eligible patients were enrolled in the analysis. Among these patients, 22 (24%) patients showed recurrence after a median follow-up of 46.5 months. Within the fertility sparing surgery group, patients at advanced stage (≥stage II), of serous type, with micropapillary and bilateral tumors were associated with a higher recurrence rate and a shorter recurrence interval. In terms of different modalities of fertility sparing surgery, adnexectomy was remarkably favored over cystectomy-including (P = 0.012); unilateral salpingo-oophorectomy had better prognosis than cystectomy and bilateral cystectomy was favored over unilateral salpingo-oophorectomy+contralateral cystectomy. Univariate Cox regression analysis indicated that the International Federation of Gynecology and Obstetrics stage (≥Stage II), the presence of bilateral and micropapillary lesions, and the application of cystectomy-including surgery were correlated with poorer disease-free survival, while the mucinous type of borderline ovarian tumors was related to improved disease-free survival. In this study, a total of 22 patients attempted to conceive and 15 (68%) of these patients achieved successful pregnancy.ConclusionsUnilateral salpingo-oophorectomy and bilateral cystectomy should be recommended as the preferred choice of treatment for young patients with unilateral and bilateral borderline ovarian tumor who desire to preserve fertility. In addition, borderline ovarian tumor patients at advanced stage (≥stage II), of serous type, with micropapillary and bilateral tumors should pay more attention to the risk of recurrence. Therefore, these patients should choose fertility sparing surgery carefully and attempt to achieve pregnancy as soon as possible.

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“…11 The re-ported rate of pregnancy in BOTs treated with conservative surgery varies between 32 and 65%. 12 In conclusion, it is important to make a detailed examination of ovarian cysts to ensure that any potential malignancy is not overlooked in young patients who wish to retain their fertility.…”

Section: Discussionmentioning

confidence: 99%

Management of a Giant Border-line Malign Musinous Tumor of the Ovary in an Infertile Woman

Koltan¹,

Hasdemir²,

Pekindil³

et al. 2018

Turkiye Klinikleri J Case Rep

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ucinous tumors account for 12-15% of all ovarian tumors. 1 Although the vast majority of these tumors are benign (75%), borderline (atypical proliferative) types (10%) and carcinomas (15%) are also seen. It was thought that mucinous carcinomas of the ovary may develop from benign and mucinous borderline tumors. 2 Mucinous borderline ovarian tumors (BOTs) are classified as gastrointestinal type (85%) and seromucinous type (15%), depending on their histological architecture and type of tumor cells. Seromucinous ovarian tumors are not common and their clinical behavior is not as aggressive as much as other types. The reported mortality rate with these tumors is low. 2 There is slightly increased relationship between infertility and BOTs. 3,4 CASE REPORT We presented a case of a 37-year-old woman who had been undergoing infertility treatment for 6 years. Diagnostic laparoscopy performed for infertility two years earlier had revealed a normal looking uterus and a normal looking left ovary. A cyst on the right ovary containing serous fluid was aspirated during the procedure. The patient had undergone a second ovulation induction protocol for primary infertility 6 months earlier. She presented to our hospital with an abdominal mass running into the diaphragm. Ultrasonographic and magnetic resonance imaging investigations showed a 28×30 cm cystic mass with septations ,possibly oriented from the right ovary and filling the abdominal cavity, free fluid in the pelvic and perihepatic sides, and no

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Fertility sparing treatment in borderline ovarian tumours

Cited by 24 publications

References 89 publications

Identification of factors that impact recurrence in patients with borderline ovarian tumors

Identification of factors that impact recurrence in patients with borderline ovarian tumors

The impact of clinicopathologic and surgical factors on relapse and pregnancy in young patients (≤40 years old) with borderline ovarian tumors

Management of a Giant Border-line Malign Musinous Tumor of the Ovary in an Infertile Woman

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