Two-thirds of patients diagnosed with borderline ovarian tumors (BOT) who desired pregnancy experienced a live birth after undergoing conservation surgery, according to a recent study out of France.
“BOT are rare gynecologic tumors and represent around 10% to 15% of epithelial ovarian tumors,” the researchers wrote. “The referral treatment of BOT is surgery, consisting of bilateral adnexectomy. However, BOT are often diagnosed in young patients and at an early stage. Therefore, fertility-sparing surgery is a common option.”
In this study, the researchers looked at patients diagnosed with BOT from the French National Network dedicated to Ovarian Malignant Rare Tumors between 2010 and 2017. Among 527 patients with BOT, 125 were 43 yearszASX or younger and treated with conservative surgery. Of these, 112 patients returned a questionnaire on recurrence and fertility.
About one-half (46%) of respondents presented a desire of pregnancy. Thirty of these patients had a FIGO IA tumor and 20 were treated with bilateral cystectomies. At a median follow-up of 57 months, 63% of patients presenting with desire of pregnancy had at least 1 live birth.
“Among the live birth, around one quarter were obtained after ovarian induction or in vitro fertilization procedures, with no more risk of recurrence,” the researchers wrote.
Fifty-two patients had borderline local recurrences. The 2-year disease-free survival was 87.6%. Sixteen patients had both recurrence and pregnancy, with recurrence occurring prior to pregnancy in half of the cases.
The researchers identified no factors associated with recurrence or pregnancy.
“All these results suggest that a second fertility-sparing surgery can be an option after local borderline recurrence in the case of pregnancy desire,” the researchers wrote. “However, we have to be careful with the type of fertility-sparing surgery we propose to our patients. Indeed, in our study, bilateral cystectomy was associated with worse prognosis, with no improved fertility.”
Chevrot A, Pouget N, Bats AS, et al. Fertility and prognosis of borderline ovarian tumor after conservative management: results of the multicentric OPTIBOT study by the GINECO & TRMG Group. Gynecol Oncol. 2020;157(1):29-35.