Pregnancy after fertility‐sparing surgery for borderline ovarian tumors

Lian, Chengying; Chen, Xiujuan; Ni, Yihua; Huang, Xiaochen; Lin, Yuan

doi:10.1016/j.ijgo.2016.03.018

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…This might be due to women delaying their pursuit of childbearing owing to a fear of recurrence or having no desire to become pregnant. The mean time from surgery to birth in our cohort was 32 months, similar to what has been reported by others (mean time to pregnancy range 13-37.5 months) (19,21,22).…”

Section: Discussionsupporting

confidence: 90%

Reproductive and obstetrical outcomes with the overall survival of fertile-age women treated with fertility-sparing surgery for borderline ovarian tumors in Sweden: a prospective nationwide population-based study

Johansen

Dahm‐Kähler

Staf

et al. 2021

Fertility and Sterility

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Objective: To assess the efficacy of fertility-sparing surgery (FSS) in terms of reproductive outcomes by following FSS for borderline ovarian tumors (BOTs) and comparing the safety of FSS versus radical surgery (RS). Design: Nationwide cohort study based on prospectively recorded data. Setting: Sweden. Patient (s): All women of reproductive age (18-40 years) treated in Sweden for stage I BOT with the use of FSS or RS from 2008 to 2015, identified in the Swedish Quality Registry for Gynecologic Cancer (SQRGC). Interventions (s): FSS or RS. Main Outcome Measure (s): Reproductive outcomes: natural conception, use of assisted reproductive technology (ART), live birth and obstetrical outcomes. Safety outcome: overall survival (OS) rates, comparing women undergoing FSS versus RS. The FSS cohort was linked to the Swedish Medical Birth Register to identify all women who had given birth after FSS and to obtain detailed obstetrical data. For information on ART treatment, the National Quality Registry for Assisted Reproduction was consulted. OS rate comparisons were conducted by means of Kaplan-Meier estimates. Result (s): Of the 277 women with BOTs, 213 (77%) underwent FSS, 183 (86%) unilateral salpingo-oophorectomy, and 30 (14%) cystectomy. Following FSS, 50 women gave birth to 62 healthy children, 8% of which were preterm. Only 20 (9%) of the women underwent ART treatment. OS was similar in women treated with FSS and RS. Conclusion (s): Natural fertility was maintained after FSS; only 9% required ART treatment. FSS was also deemed to be equivalent to RS regarding survival outcome. (Fertil Steril Ò 2021;115:157-63. Ó2020 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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Section: Discussionsupporting

confidence: 90%

Reproductive and obstetrical outcomes with the overall survival of fertile-age women treated with fertility-sparing surgery for borderline ovarian tumors in Sweden: a prospective nationwide population-based study

Johansen

Dahm‐Kähler

Staf

et al. 2021

Fertility and Sterility

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“…Fertility rate has been reported at about 50% in 2 studies and 74% in another study (18,20,21). Fertility rate was 58% in the current research, and there were no significant difference between the 2 groups in the method of surgery, pathologic type, stage of BOT, bilateral or unilateral location of tumor and cystectomy or USO; on the other hand, these factors had no effect on fertility.…”

Section: Discussioncontrasting

confidence: 42%

Recurrence and Fertility Rate in Females with Borderline Ovarian Tumor

Mousavi

Shooshtari

Nassiri

et al. 2017

J Obstet Gynecol Cancer Res

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Background: Currently, the prevalence of borderline ovarian tumors 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 science, and recurrence rate, fertility rate, and the effect of different variables were studied. Results: There were significant correlations between 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.

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“…The multi-disciplinary team must include a gynecologic surgeon specialized in oncologic surgery, an oncologist, an experienced radiologist and an expert in reproductive medicine, and should provide a personalized treatment plan according to patient age, ovarian reserve, previous treatments, individual risk of recurrence, and patient preference [ 35 , 36 ]. FP counselling visits should ideally take place before BOT surgery in order to discuss with the chances of spontaneous fertility before and after surgery, fertility preserving options with its limits and risks [ 36 , 37 ]. Systematic review of MRI imaging is useful to determine pre-operatively the degree of possible invasion of one or both ovaries in order to decide with the patient the best option and to avoid restaging surgeries.…”

Section: Discussionmentioning

confidence: 99%

Serous Borderline Ovarian Tumor Diagnosis, Management and Fertility Preservation in Young Women

Carbonnel

Layoun

Poulain

et al. 2021

JCM

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Borderline ovarian tumors (BOT) represent about 10 to 20 percent of all epithelial tumors of the ovary. They constitute intermediate lesions between benign ovarian cysts and invasive carcinomas. They often occur in young women of reproductive age, and, albeit with a favorable prognosis, it may recur on the ipsilateral or contralateral ovary. Controversies surround the diagnostic criteria used for their assessment, and the optimal management to minimize their risk of recurrence and/or transformation into malignant carcinoma. Fertility preservation (FP) is considered a priority in the management of these patients, and studies aim at finding the safest and most effective way to help women with BOT history conceive with minimal risk. We present the experience of a single institution in managing three cases of serous BOT in young nulliparous women, followed by a thorough review of the existing literature, highlighting controversies and exploring the possible FP techniques for these women.

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Pregnancy after fertility‐sparing surgery for borderline ovarian tumors

Abstract: Fertility-sparing surgery in young patients with BOTs is associated with a good pregnancy rate. However, the tumor stage and coexisting infertility factors are important considerations in selecting the optimal surgical approach.

Cited by 10 publications

References 13 publications

Reproductive and obstetrical outcomes with the overall survival of fertile-age women treated with fertility-sparing surgery for borderline ovarian tumors in Sweden: a prospective nationwide population-based study

Reproductive and obstetrical outcomes with the overall survival of fertile-age women treated with fertility-sparing surgery for borderline ovarian tumors in Sweden: a prospective nationwide population-based study

Recurrence and Fertility Rate in Females with Borderline Ovarian Tumor

Serous Borderline Ovarian Tumor Diagnosis, Management and Fertility Preservation in Young Women

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