Short-term Outcomes and Pregnancy Rate After Laparoscopic Fertility-Sparing Surgery for Borderline Ovarian Tumors

Abstract

ObjectiveWe investigated the short-term outcomes and pregnancy rate after a laparoscopic approach to fertility preservation in patients with borderline ovarian tumors (BOTs).MethodsClinic-pathologic variants of patients with BOTs who underwent conservative surgery at the Tianjin Central Hospital of Obstetrics and Gynecology between January 2009 and July 2015 were retrospectively analyzed.ResultsAmong 211 patients with BOTs, 74 (35.1%) received conservative surgery (44 cases using a laparoscopic approach and 30 cases using a laparotomy approach). The mean age of the laparotomy group was significantly younger than that of the laparoscopic group (P = 0.024). The maximal longitude of the tumor in the laparotomy group was significantly longer than that in the laparoscopic group (P < 0.001). The number of incomplete surgery cases in the laparoscopic group was significantly greater than that in the laparotomy group (P < 0.001). The 2 groups showed no significant differences in gravidity and parity before surgery, abnormality of serum tumor makers, tumor lateralities, ascites, histology, duration of follow-up, pregnancy rate after surgery, or postoperative recurrence. Total recurrent rate was 6.7% (5/74). Two cases in laparotomy group and 3 cases in laparoscopic group relapsed respectively. There was no significant difference of recurrent rate between the 2 groups. The total pregnant rate was 33.8% (25/74). Nine patients (30%) in the laparotomy group and 16 patients (36.4%) in the laparoscopic group became pregnant during follow-up respectively. There were no significant differences in the postoperative durations of pregnancy, pregnancy type, age at pregnancy, tumor lateralities, ascites, or type of pathology between 2 groups. The pregnancy rate of incomplete surgery cases in laparoscopic group was significantly higher than that of laparotomy group (P = 0.011). No recurrence occurred among the pregnant cases.ConclusionsA comprehensive laparoscopic surgery was not performed in incomplete surgery patients undergoing complete exploration. Good short-term outcomes and pregnancy were observed in patients receiving conservative laparoscopic surgery for BOTs, especially in patients receiving incomplete conservative laparoscopic surgery.

Obstetric outcomes after conservative management of ovarian borderline tumors in women of reproductive age: A single center experience

“…There was no difference in the pregnancy rate between patients who underwent cystectomy and unilateral adnexectomy, which is consistent with other papers [21,22].…”

“…Other studies have reported lower pregnancy rates of 23% to 44% in conservatively treated patients [2,[19][20][21][22]. A higher rate of 40-88% has been reported among patients who retrospectively declared the child wishing [3,12,22,23].…”

“…The surgical approach (laparoscopy versus laparotomy) had no impact on the pregnancy rate in our study. In addition, it does not seem to play a role in treatment or survival [7,21]. The recommendation concerning the use of laparoscopy only suggests avoiding cyst rupture and to evacuate the tumor with the protection of an endobag [7].…”

Oncologic and obstetric outcomes of fertility-sparing surgery for borderline ovarian tumors in women of reproductive age: a retrospective cohort study

“…Many studies were conducted regarding the pregnancy rates of BOT patients after FSS, but few addressed live birth rates. Zhao [20] reported a total pregnant rate of 33.8%. Lee also reported that 26 of the 32 patients (81.3%) had successful pregnancies [16].…”

Recent updates in Management of Borderline Ovarian Tumors

“…The standard radical surgery should be performed to women who has completed their primitive appendiceal neoplasm. (Figure 8) [23] . Although fertility sparing treatments for BOTs may allow future pregnancies, it also carries and increased risk of recurrence.…”