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Abstract
Introduction/Background Serous borderline ovarian tumors (sBOT) are associated with good prognosis and can be safely treated with fertility-sparing surgery (FSS) in order to preserve endocrine and reproductive function, even if the risk of recurrence or progression is well described. Recurrences occur more frequently in the advanced stages, but little is known about their management. In this retrospective study, we report the largest single-center series of advanced sBOT who underwent multiple FSS with a long-term follow-up, with particular emphasis on the prognostic factors.
Methodology Women aged < 45 years old treated by FSS for sBOT FIGO stage II and III from February 1997 to July 2023, were collected. All women underwent a quarterly sonographic follow-up and dosage of Ca125 for the first two years, and every six months thereafter. They were followed at our institutions by the same expert sonographers.
Results Hundred patients with advanced-stage sBOT performed FSS. The median age was 29.3 years (range 17–43) and the median follow-up time was 111.5 months (range 65.2, 180.7). Fifteen patients had invasive implants, and 28 had microinvasion. We observed 113 relapses in 73 patients: 36% with one relapse, 22% with two, 9% with three, and 4% and 2% with 4 and 5 relapses respectively. Progression to low-grade serous tumors was observed in 7 patients, and the overall survival of the whole series was 95%. The relapse risk was high in the first 48 months, while the time lapse between relapses doubled. We observed 35 pregnancies with 30 live births and 5 miscarriages.
In the univariate analysis, only the largest diameter of the lesion was statistically significant for the relapse risk.
Conclusion FSS is feasible in advanced sBOT without compromising overall survival. Multiple FSS provide increasing disease-free intervals.
Disclosures The authors declare that they have no conflict of interest.
