Fertility preserving surgical treatment of borderline ovarian tumour: long-term consequence for fertility and recurrence

BACKGROUND: Borderline tumours of the ovary comprise >10% of all epithelial ovarian tumours, and about one-quarter of these tumours are seen in women of fertile age. In the present study, the outcomes with regard to fertility and recurrence were followed in patients with borderline tumours, who were treated with ovarian and uterus preserving surgery. METHODS: Of 101 women surgically treated for borderline tumours in our institution, 22 underwent fertility preserving surgery, defined as the preservation of at least part of one ovary and the uterus. A retrospective follow up of these patients was conducted. RESULTS: The 22 patients (mean age 30.5 years) underwent surgery with either unilateral salpingoophorectomy (USO; n=14) or USO combined with cystectomy of the contralateral ovary (n=8). All these patients had tumours of FIGO-stage 1 (1a = 13; 1b = 3; 1c = 6). No recurrence was seen during the follow up time (mean 8.1 years; range 5-12 years). Thirteen of the 22 patients have, since the surgery, been given a chance of pregnancy (10 actively aimed to achieve pregnancy; 3 with no contraceptive during the follow up period), and 9 of the 13 patients have become pregnant. Seven patients conceived spontaneously and 2 became pregnant through IVF. Eight of the 9 pregnant patients have given birth to a total of 14 infants, all born at term. CONCLUSION: This study shows that borderline ovarian tumours in patients of fertile age can be successfully treated conservatively to preserve fertility with no apparent risk of recurrence.