Objectives Borderline ovarian tumours (BOT) are a unique category of ovarian tumours. National guidance states regular sonographic follow up is essential after fertility sparing surgery (FSS), whereas, follow up in patients with early disease after BSO is uncertain. Our aim was to audit current practice and determine local recurrence rate.

Methods A retrospective single centre study over a 10-year period to compare current standard of care to the BGCS and Local Network Guidelines.

Results 78 patients were diagnosed with BOT during the 10-year period. 9 patients had FSS, the majority were mucinous BOT (77.8%) and stage 1 disease (88.9%). 44.4% have had or plan to have completion surgery and remaining 55.6% had variable sonographic/clinical follow up to a maximum 5 years. 69 patients had non-fertility sparing surgery, the majority were serous BOT (55.1%). 78.2% had stage 1 disease, 44.4% were discharged, 40.7% enrolled in the Borderline Ovarian Trial (annual review and CA125) and the remaining 14.8% had variable follow up. 14.5% had stage 2 or 3 disease, 60% received standardised follow up for 5 years, 30% enrolled in the Trial and 10% discharged. 2 patients (2.6%) experienced a malignant recurrence, 1 serous and 1 mucinous BOT. Both had initial pelvic clearance surgery with full staging.

Conclusions In line with guidance, all patients who had FSS underwent follow up, and the majority of patients with early stage disease after BSO were appropriately discharged. Overall, 9.2% of patients had variable follow up that requires standardisation. Risk of recurrence is low, however, both cases were malignant.