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Prognostic Factors for Recurrence After Fertility-Preserving Surgery in Patients With Borderline Ovarian Tumors: A Systematic Review and Meta-analysis of Observational Studies
  1. Xiaobing Jiao, MD,
  2. Jun Hu, MD and
  3. Lirong Zhu, MD
  1. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
  1. Address correspondence and reprint requests to Li-Rong Zhu, MD, Department of Obstetrics and Gynecology, Peking University First Hospital, No. 1, Xi’anmen Street, Beijing 100034, China. E-mail: lirongzhu16{at}


Objective The aim of this study was to find the unfavorable prognostic factors for recurrence after fertility-preserving surgery (FPS) in patients with borderline ovarian tumors (BOTs).

Methods To perform a meta-analysis to compare the recurrence rates of BOT patients after FPS according to different prognostic factors, we searched PubMed, EMBASE, and Cochrane for observational studies. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with a fixed-effects model.

Results We analyzed 32 studies that included 2691 BOT patients who underwent FPS, 383 patients of whom had a relapse in the follow-up. In meta-analysis, risks associated with recurrence in patients with unilateral cystectomy (OR, 2.49; 95% CI, 1.86–3.33) or serous borderline ovarian tumors (OR, 3.15; 95% CI, 1.97–5.02) were significantly increased, and there was no significantly increased OR for patients with laparoscopy compared with those with laparotomy (OR, 0.96; 95% CI, 0.57–1.60).

Conclusions Unilateral cystectomy (19.4%) and serous BOTs (19.2%) are significantly associated with higher recurrence rates, and no negative impact of laparoscopy on recurrence can be demonstrated when compared with laparotomy in the meta-analysis.

  • Atypical proliferative tumor
  • Borderline ovarian tumor
  • Fertility-preserving surgery
  • Low malignant potential tumor
  • Recurrence

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  • The authors declare no conflicts of interest.