Borderline ovarian tumors: Recurrence patterns and management in a single-institution retrospective study

We aimed to evaluate the factors associated with disease recurrence, recurrence patterns, and obstetric outcomes of borderline ovarian tumors (BOT). The primary outcome was to identify prognostic factors for disease recurrence-the secondary outcomes included recurrence sites and obstetric results.

This study included patients diagnosed with BOT at Başkent University. Data were obtained from patient files and hospital records. Histopathological results were re-evaluated based on the new 2020 World Health Organization classification. Stage I or II disease is considered as early-stage disease, while stage III was deemed as advanced. Risk factors for disease recurrence were assessed for early-stage and advanced-stage diseases. Survival was measured from the time of diagnosis.

A total of 142 patients were included with a median follow-up time of 100.5 (range: 20-266) months. Recurrence occurred in 24 (16.9 %) patients with a 5-year recurrence-free survival rate of 86.3 %, and no deaths recorded. The main site of tumor recurrence was the same ovary (12/24, 50 %). In multivariate analysis, cystectomy was identified as a risk factor for recurrence in the early stage (HR: 4.28; 95 % CI: 1.40-13.08, p = 0.011). The pregnancy rate was 76.7 % among 43 patients who attempted to conceive. There was no significant difference in obstetric outcomes between unilateral salpingo-oophorectomy (USO) and cystectomy (p = 0.223).

The risk of recurrence in patients with BOT was higher in those who underwent cystectomy, while obstetric outcomes were similar between cystectomy and USO. Fertility-sparing surgery appears to be an appropriate choice for young women, offering satisfactory obstetric outcomes even in advanced-stage disease.