Introduction/Background Borderline ovarian tumours (BOTs) have an average age at the diagnosis of 40 years and around 30% of patients have not completed their childbearing. Fertility sparing surgery (FSS) is considered the best treatment without an impact on the overall survival rate. However, the safety of laparoscopy for FSS in BOTs remains limited with short follow-up and ESGO and ESMO guidelines indicate open surgery as the standard approach. We aim to assess the long-term oncological safety of laparoscopy in the FSS treatment of BOTs.
Methodology This is a retrospective single-centre study including 34 women who underwent laparoscopic FSS for BOTs, between January 2000 and June 2019 at Hospital Clinic of Barcelona. FSS was considered when the uterus and at least part of the ovarian tissue was conserved. Patients were scheduled for transvaginal ultrasound and blood test including CA125 for 10 years or until loss. Chi-square and Fisher’s tests were applied for qualitative variables. Student T-tests or Mann-Whitney tests were applied for continuous variables.
Results Median age was 32 years. Unilateral cystectomy was performed in 15 patients (44.1%), bilateral cystectomy in 2 (5.9%), unilateral adnexectomy in 14 (41.1%) and unilateral adnexectomy with contralateral cystectomy in 3 (8.9%). Mean tumour size and CA125 at diagnosis was 8.72 cm and 21, respectively. Twelve patients (35.2%) relapsed with a mean follow-up time of 95 months, being earlier in case of unilateral cystectomy (median 30 months, IQR 29) and bilateral cystectomy (18 months, IQR 0), compared to unilateral adnexectomy (median 78 months, IQR 64). Up to 41% relapses occurred after 45 months. Surgical factors related to laparoscopy and risk of recurrence were studied without finding significant differences.
Conclusion Laparoscopic FSS for BOTs is a safe treatment in patients with reproductive desire without impacting on overall survival. A long-term follow-up is essential to detect late recurrences.
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