Long-Term Survival Impact and Obstetric Outcomes After Fertility Preservation Surgery in Borderline Ovarian Tumors

Abstract Purpose To assess the long-term oncologic and obstetric outcomes after fertility sparing surgery (FSS) in women with borderline ovarian tumors (BOTs). Material and Methods This retrospective study included 141 BOT patients. Specimens of patients were reevaluated according to new WHO–2020 classification of ovarian tumors. Obstetric outcomes were evaluated for FSS subgroup. Survival analysis were performed in the whole group. Results FSS and standard surgery applied 93 and 48 patients, respectively. Median follow-up time was 86 months. The 5-year OS and DFS rates were 100% and 87%, respectively. FSS (p:0.000) and regional disease (stage III disease) (p:0.002) were associated with a shorter 5-year DFS. Regional disease was the only prognostic factor for DFS (p:0.002). Analysis of FSS subgroup revealed regional disease (p:0.004) as a significant factor associated with decreased 5-year DFS. Cystectomy was associated with a shorter 5-year DFS when compared to USO (65.6% vs. 88.7%, respectively) (p:0.031). Pregnancy rate was 76.7% among 43 patients who attempted to conceive. There were 34 livebirths among 33 women. Conclusion Regional disease appeared to be the only significant factor for decreased 5-year DFS. FSS seems to be an appropriate choice for young women with BOTs.