Fertility-Sparing Surgery for Ovarian Mucinous Tumors and Risk of Recurrence

Background Fertility-sparing surgery (FSS) is increasingly utilized in young women with early-stage ovarian tumors; however, data specific to mucinous histology and recurrence risk remain limited. Objective The objective of this study is to evaluate oncologic outcomes and recurrence patterns following FSS in patients with mucinous ovarian tumors. Methods This retrospective study included 32 patients with histologically confirmed mucinous ovarian tumors managed with FSS at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan, a tertiary care center. Clinicopathological variables, surgical details, and follow-up outcomes were analyzed. Disease-free survival (DFS) and overall survival (OS) were assessed over a median follow-up of 18 months. Results The median age was 25-26 years (range 18-40). Histologically, 20 patients (62.5%) had mucinous borderline tumors, including 12 infiltrative subtypes, while 12 (37.5%) had mucinous carcinoma. The median tumor size in infiltrative tumors was 10 cm (range 4-30 cm). Laparotomy was performed in 68.8% of cases. At 18 months, OS was 100%, and DFS was 81.2%. Recurrence occurred in 6 patients (18.8%), predominantly in mucinous carcinoma (33.3%) and infiltrative borderline tumors (16.7%). Recurrences involved the contralateral ovary and omentoperitoneal surfaces. Tumor markers, cancer antigen 125 (CA-125) and carcinoembryonic antigen (CEA), remained normal in all patients. Conclusion FSS is a safe option in selected patients with mucinous ovarian tumors, demonstrating excellent survival outcomes. However, recurrence risk is influenced by histological subtype, particularly mucinous carcinoma and infiltrative borderline tumors, necessitating careful patient selection and close follow-up.