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235 Borderline ovarian tumors (BOT): Clinico-pathological features, oncological and fertility outcomes
  1. U Chishti,
  2. AB Aziz,
  3. H Aziz and
  4. N Sikander
  1. Aga Khan University Hospital, Obstetrics and Gynaecology, Karachi, Pakistan


Introduction/Background*BOT are heterogeneous subset of epithelial ovarian tumors, predominantly diagnosed at earlier stages with overall excellent prognosis. Though less but the risk of recurrence remains a matter of concern. In this study, we analyzed the clinicopathological variables, oncological and fertility outcomes of BOT.

Methodology This was a retrospective, cross-sectional study conducted at the department of Obstetrics & Gynaecology, Aga khan hospital Karachi from 2002 to 2018.

Result(s)*A total of 73 patients with BOT were included with a mean age of 43 years. Thirty five (48%) patients had fertility sparing surgery (FSS) while 38(52%) underwent debulking surgery. Pre-operative CA-125 IU level was 125 in FSS group and 67 in debulking group.

Laparotomy was the common surgical approach in both the groups with Only 5 (14%) patients in FSS group had minimal access surgery. Only 3 patients (8%) had residual disease in debulking group.

Majority of patients in both FSS and debulking groups had FIGO stage 1 disease 34 (97%) and 34(89%) respectively. The serous histological type was common in both the groups while unilateral lesion more prevalent in the FSS group (83% vs. 68%).

Recurrence was reported in 3(8.6%) patient in FSS group, while 1 (2.6%) in debulking group. The average time to recurrence was 31 months (11-51 months). Among the 4 recurrences 3 had either capsule breach or surface disease and 3 had mucinous and 1 was serous histotype. Among the recurrences 3 were in stage 1 and one in stage 3C. Cytology was positive in 4(11.4%) patients in FSS group and 8(21%) patients in debulking group but it did not have any impact on recurrence. Three patients (8.5%) conceived in FSS and had live births. Surgical approach was laparotomy in these patients and all of them had stage 1A disease.

Conclusion*BOT have an excellent prognosis. Relapses occur late in the trajectory of disease and hence regular follow-ups are important. Recurrences are independent of age and are more common in mucinous tumors with surface disease and can occur even in early stages.

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