Risk factors of recurrence and pregnancy in patients with borderline ovarian tumors: a retrospective study with 16-year follow-up

Risk factors of recurrence and pregnancy in patients with borderline ovarian tumors: a retrospective study with 16-year follow-up | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Risk factors of recurrence and pregnancy in patients with borderline ovarian tumors: a retrospective study with 16-year follow-up Qi Lu, Yupeng Deng, Zhiqiang Zhang, chongdong liu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1448580/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Objective: This study analyzed the risk factors affecting recurrence in patients with borderline ovarian tumors （BOTs）after radical surgery and the risk factors influencing recurrence and pregnancy in patients after fertility sparing surgery (FSS). Methods: This is a retrospective cohort study. Data was collected from clinical data of patients in the Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2005 to November 2021. The clinicopathological and surgical variables were analyzed by univariate analyses and survival curves. Results: A total of 169 BOT patients were included in this study. The median age was 45 years. Median follow-up time was 81months. Among these patients, 21 patients relapsed. There were 60 patients receiving FSS, of the 16 patients attempting to conceive, 13 patients have successfully conceived spontaneously. In univariate analyses, FIGO stage, invasive implantation, and chemotherapy were risk factors for recurrence of BOTs. FIGO stage was the only one risk factor after multivariate analysis. Tumor size and tumor site were risk factors for recurrence of BOTs receiving FSS. We didn’t find any risk factor for pregnancy of BOTs receiving FSS. Conclusion: After univariate analysis and multivariate analysis, we found some risk factors for recurrence after radical surgery or FSS, but they didn’t affect the overall survival rate and pregnancy rate. Laparoscopy procedure is recommended and chemotherapy is not recommended for patients receiving FSS. We suggest that patients who preserve fertility should get pregnant as soon as possible and follow up closely. borderline ovarian tumor recurrence pregnancy fertility sparing surgery Figures Figure 1 Figure 2 Introduction Borderline ovarian tumors (BOTs), first described by Taylor in 1929, account for 10% -20% of epithelial ovarian tumors. BOTs are characterized by atypical epithelial proliferation without stromal invasion. Its histopathology and biological behavior are between benign and malignant tumors [ 1 ]. BOTs of every surface epithelial cell type (serous, mucinous, endometrioid, clear cell, transitional cell and mixed epithelial cell) have now been reported. However, the serous and mucinous BOTs are the most common by far [ 2 ]. It was estimated that about 2.5 to 5.5 per 100,000 women were diagnosed as BOTs every year. BOTs of all stages combined have favorable 5-year and 10-year survival rates of 95% and 90%, respectively [ 3 ]. The recommended treatment for BOTs consists of peritoneal washing, hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies. Appendectomy is also recommended for women with mucinous BOTs. Compared with malignant tumors, BOTs are more frequently diagnosed in young women of childbearing age, and approximately one-third of them are diagnosed before 40 years of age [ 4 ]. For the past ten years, with the implementation of the two-child policy in China and delay in childbearing age, fertility sparing surgery (FSS) is widely accepted for treatment of BOTs. So far, the main issue of BOTs is that there is still no consensus on the risk factors for recurrence and pregnancy. Therefore, the purpose of this study was to analyze the influencing factors for recurrence of BOTs and evaluate the efficacy of FSS in terms of fertility outcomes. Materials And Methods Consecutive patients were diagnosed as BOTs in Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2005 to November 2021 were screened for inclusion in the analysis. Inclusion criteria: 1) Patients with initial treatment and operation in Beijing Chaoyang Hospital affiliated to Capital Medical University. 2) Patients with BOTs that were confirmed by pathology; 3) patients’ diagnoses were based on the World Health Organization (WHO) pathological diagnosis standard of BOTs; 4) patients with complete clinical data and follow-up data. Exclusion criteria: 1) Patients complicated with gynecological malignant tumors; 2) Patients have a history of other malignant tumor; 3) Patients complicated with severe heart, lung, liver, kidney dysfunction; 4) patients without complete clinical data and follow-up data. The clinical pathological data concerned age, history of fertility, menopause, chief complaint, tumor size, tumor site, pathology, micropapillary pattern, invasive implantation, surgical approach, surgery with or without fertility preserving, lymphadenectomy, omentectomy, FIGO stage (2014 FIGO classification system), preoperative CA125. Treatment Surgery without fertility preserving consists of peritoneal washing, hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies. Appendectomy was performed for patients with mucinous BOTs. Fertility sparing surgery was defined as the preservation of the uterus and at least part of one ovary. It includes the following surgical methods: unilateral cystectomy (UC), unilateral salpingo-oophorectomy (USO), bilateral cystectomy (BC), unilateral salpingo-oophorectomy combined with contralateral ovarian cystectomy (USO + CC). There is no evidence supporting lymph node dissection in borderline ovarian tumors. Adjuvant treatment is not accepted for the standard care of BOT patients. The indications of chemotherapy or radiotherapy depended on the pathological results, the possibility of residual disease, and invasive peritoneal implants. Follow-up Patient follow-up consisted of physical and gynecological examinations, CA-125, and ultrasound scan every 3 months during the first 2 years and every 6 months afterwards. Disease-free survival (DFS) defined as the duration from primary surgery to the first recurrence or the last visit. Overall survival (OS) defined as the duration from primary surgery to death or the last visit. Data Analysis Data were statistically analyzed using SPSS 25.0 statistical software. The comparison between groups was performed by t-test. The adoption rate of counting data was expressed by chi-square test and Fisher exact probability method. The variables with statistically significant differences in univariate analysis were included in the COX regression model for multivariate analysis. DFS and OS were assessed using the Kaplan-Meier method, whereas statistically significant difference was examined by log rank test. The difference is statistically significant at P༜0.05. Results A total of 169 BOT patients from January of 2005 to November of 2021 in Beijing Chaoyang hospital were included in the study. The median age was 45 years (range, 14–88 years), and 49 patients (29%) had not history of fertility. Median follow-up time was 81months (1-203months). The characteristics of patients are shown in Table 1 . Majority of patients (54.4%) found the disease by physical examination, then abdominal pain. 55% patients’ tumors diameter of BOTs were larger than 10 cm and 81.7% were unilateral. The most common pathology type was serous (48.5%), then mucinous (43.8%). 57.4% patients underwent laparoscopic surgery. There were 127 patients diagnosed at early stage. Table 1 Clinicopathological and biological data of BOT patients characteristic Number Percentage (%) Median age (min, max) 45 (14–88) History of fertility No 49 29 Yes 120 71 Menopause No 105 62.1 Yes 64 37.9 Chief complaint Abdominal pain 48 28.4 Touching mass 9 5.3 Physical examination 92 54.4 Others 20 11.8 Tumor size (cm) ༜10 76 45 ≥10 93 55 Tumor site Unilateral 138 81.7 Bilateral 31 18.3 CA125 ≤35 65 38.5 ༞35 57 33.7 None 47 27.8 Frozen section diagnosis Benign 49 29 Borderline 104 61.5 None 16 9.5 Ovarian tumor rupture Spontaneous rupture 24 14.2 Intraoperative rupture 6 3.6 None 139 82.2 Pathology Serous 82 48.5 Mucinous 74 43.8 others 13 7.7 Micropapillary pattern No 76 45 Yes 93 55 Invasive implantation No 159 94.1 Yes 10 5.9 Surgical approach Laparotomy 97 57.4 Laparoscopy 72 42.6 Lymphadenectomy No 71 42 Yes 98 58 Omentectomy No 52 30.8 Yes 117 69.2 Fertility-sparing surgery No 109 64.5 Yes 60 35.5 FIGO stage I 127 75.1 ≥II 42 24.9 Chemotherapy No 133 78.7 Yes 36 21.3 Involvement ovary Reserved 13 7.7 Excision 156 92.3 Complete Staging surgery No 61 36.1 Yes 108 63.9 A total of 21 patients relapsed, with a recurrence rate of 12.4%. The shortest interval of recurrence was 2 months and the longest was 148 months. The median recurrence interval was 62 months. Through univariate analysis, we found that FIGO stage, invasive implantation and chemotherapy affected BOT recurrence, and the differences were statistically significant ( P < 0.05). The recurrence rate of FIGO stage I was 8.7% and FIGO stage II and III was 24.4%. The recurrence rate of the patients with invasive implantation was 40% and patients without invasive implantation was 10.8%. The recurrence rate of patients receiving chemotherapy was 25% and not receiving chemotherapy was 9%. The survival curves of patients in these groups are provided in Fig. 1 . Univariate analysis of factors affecting recurrence are shown in Table 2 . Through multivariate analysis, we found that FIGO stage was only one independent risk factor affecting BOT recurrence rate ( P = 0.039). Table 2 Univariate analysis of factors affecting recurrence in patients with BOT characteristic No recurrence (%) Recurrence (%) P value Median age (min, max) History of fertility No 43 (87.8) 6 (12.2) 0.964 Yes 105 (87.5) 15 (12.5) Menopause 0.982 No 92 (87.6) 13 (12.4) Yes 56 (87.5) 8 (12.5) Tumor size (cm) 0.794 ༜10 66 (86.8) 10 (13.2) ≥10 82 (88.2) 11 (11.8) Tumor site 0.196 Unilateral 123 (89.1) 15 (10.9) Bilateral 25 (80.6) 6 (19.4) CA125 0.691 ≤35 54 (88.5) 7 (10.8) ༞35 84 (86.7) 5 (8.9) None Frozen section diagnosis 0.559 Benign 44 (89.8) 5 (10.4) Borderline 89 (85.6) 15 (14.4) None 15 (93.8) 1 (6.2) Ovarian tumor rupture 0.438 No 123 (88.5) 16 (11.5) Yes 25 (83.3) 5 (16.7) Pathology 0.225 Serous 73 (89.0) 9 (11.0) Mucinous 62 (83.8) 12 (16.2) others 13 (100) 0 (0) Micropapillary pattern 0.466 No 65 (85.5) 11 (14.5) Yes 83 (89.2) 10 (10.8) Invasive implantation 0.006 No 142 (89.3) 17 (10.7) Yes 6 (60.0) 4 (40.0) Surgical approach 0.359 Laparotomy 83 (85.6) 14 (14.4) Laparoscopy 65 (90.3) 7 (9.7) Lymphadenectomy 0.133 No 59 (83.1) 12 (16.9) Yes 89 (90.8) 9 (9.2) Omentectomy 0.460 No 47 (90.4) 5 (9.6) Yes 101 (86.3) 16 (13.7) Fertility-sparing surgery 0.824 No 95 (87.2) 14 (12.8) Yes 53 (88.3) 7 (11.7) FIGO stage 0.035 I 116 (91.3) 11 (8.7) ≥II 32 (76.2) 10 (23.8) Chemotherapy 0.011 No 121 (90.9) 12 (9.1) Yes 27 (75.0) 9 (25.0) Involvement ovary 0.590 Reserved 12 (92.3) 1 (7.7) Excision 136 (87.2) 18 (12.8) Complete Staging surgery 0.838 No 53 (86.0) 8 (13.1) Yes 95 (88.0) 13 (12.0) In this study, 60 patients underwent fertility sparing surgery. The median age was 28 years (range, 14–46 years). There were 40 patients undergoing USO, 10 patients undergoing UC, 4 patients receiving BC and 6 patients receiving USO + CC. The recurrence rates of these patients were 10%, 0%, 25% and 33.3% respectively, indicating that the groups showed no statistically significant difference. The recurrence rate of laparoscopic group was 15% and of laparotomy was 10%, but the differences were not statistically significant ( P = 0.570). The recurrence rate of patients with tumor size smaller than 10cm was 20.7%, and tumor size larger than 10cm was 3.2%, the difference has statistically significant ( P = 0.035). The recurrence rate of patients with unilateral tumor was 8% and with bilateral tumors was 30% ( P = 0.048). Univariate analysis of factors affecting recurrence in BOT patients with FSS are shown in Table 3 . Table 3 Univariate analysis of factors affecting recurrence in BOT patients with FSS characteristic No recurrence (%) Recurrence (%) P Number 53 (88.3) 7 (11.7) Median age (min, max) 28 (14–46) 29 (24–36) 0.929 History of fertility 0.704 No 34 (87.2) 5 (12.8) Yes 19 (90.5) 2 (9.5) Tumor size (cm) 0.035 ༜10 23 (79.3) 6 (20.7) ≥10 30 (96.8) 1 (3.2) Tumor site 0.048 Unilateral 46 (92.0) 4 (8.0) Bilateral 7 (70.0) 3 (30.0) CA125 0.336 ≤35 15 (83.3) 3 (16.7) ༞35 23 (95.8) 1 (4.2) None 15 (83.3) 3 (16.7) Frozen section diagnosis 0.564 Benign 17 (85) 3 (15) Borderline 29 (87.9) 4 (12.1) None 7 (100) 0 (0) Ovarian tumor rupture 0.512 Spontaneous rupture 9 (90) 1 (10) Intraoperative rupture 4 (100) 0 (0) None 46 Pathology 0.737 Serous 23 (88.5) 3 (11.5) Mucinous 26 (86.7) 4 (13.3) others 4 (100) 0 (0) Micropapillary pattern 0.795 No 25 (89.3) 3 (10.7) Yes 27 (87.1) 4 (12.9) Invasive implantation 0.711 No 51 (87.9) 7 (12.1) Yes 1 (100) 0 (0) Surgical approach 0.570 Laparotomy 36 (90) 4 (10) Laparoscopy 17 (85) 3 (15) Lymphadenectomy 0.055 No 25 (80.6) 6 (19.4) Yes 28 (96.6) 1 (3.4) Omentectomy 0.903 No 24 (88.9) 3 (11.1) Yes 29 (87.9) 4 (12.1) Fertility-sparing surgery USO 36 (90) 4 (10) 0.297 UC 10 (100) 0 (0) BC 3 (75) 1 (25) 0.778 USO + CC 4 (66.7) 2 (33.3) FIGO stage 0.082 I 44 (91.7) 4 (8.3) ≧ II 9 (75) 3 (25) Chemotherapy 0.657 No 42 (89.4) 5 (10.6) Yes 11 (84.6) 2 (15.4) Involvement ovary 0.547 Reserved 13 (92.9) 1 (7.1) Excision 40 (87) 6 (13) Complete Staging surgery 0.228 No 25 (83.3) 5 (16.7) Yes 28 (93.3) 2 (6.7) Because of some reasons, only 16 patients still had fertility desire after operation. Among them, 13 patients have successfully conceived spontaneously and all of them had term live births. The pregnancy rate was 81.3%. There were no serious complications in obstetric and neonatal outcomes among women with live births. No tumor recurrence happened during pregnancy. The pregnancy rates in these patients receiving USO, UC, BC or USO + CC were 88.9%, 66.7%, 50% and 100% ( P = 0.899) respectively. The pregnancy rates in FIGO stage I and advanced FIGO stage were 81.1% and 80% ( P = 0.148). The pregnancy rate of patients underwent chemotherapy was 75%, which lower than patients without chemotherapy (83.3%), however, the difference was not statistically significant. The pregnancy rate in laparoscopic group was 100% and in laparotomy group was 75% ( P = 0.825). The pregnancy rates in patient with lymphadenectomy or without lymphadenectomy were 80% and 81.8%, respectively. Through univariate and multivariate analysis, no factor was found to be significantly correlated with pregnancy rate. (Table 4 ) Table 4 Univariate analysis of pregnancy factors in BOT patients with FSS characteristic Non-pregnancy N patients achieving/ attempting pregnancy (%) P Number 47 13/16 (81.3) Median age (min, max) 29 28(20–36) 0.309 History of fertility No 28 11/13 (84.6) 0.094 Yes 19 2/3 (66.7) Tumor size (cm) ༜10 21 8/10 (80.0) 0.282 ≥10 26 5/6 (83.3) CA125 ≤35 16 2/4 (50.0) 0.420 ༞35 18 6/7 (85.7) None 13 5/5 (100.0) Pathology Serous 19 7/10 (70%) 0.640 Mucinous 25 5/5 (100.0) others 3 1/1 (100.0) Micropapillary pattern No 21 7/9 (77.8) 0.601 Yes 25 6/7 (85.7) Invasive implantation No 45 13/15 (86.7) 0.592 Yes 1 0/1 (0) Surgical approach Laparotomy 31 9/12 (75.0) 0.825 Laparoscopy 16 4/4 (100.0) Lymphadenectomy No 22 9/11 (81.8) 0.152 Yes 25 4/5 (80.0) Omentectomy No 20 7/10 (70.0) 0.469 Yes 27 6/6 (100.0) Fertility-sparing surgery USO 32 8/9 (88.9) 0.899 UC 8 2/3 (66.7) BC 3 1/2 (50.0) USO + CC 4 2/2 (100.0) FIGO stage I 39 9/11 (81.8) 0.148 II 8 4/5 (80.0) Chemotherapy No 37 10/12 (83.3) 0.889 Yes 10 3/4 (75.0) Complete Staging surgery No 22 8/10 (80.0) 0.347 Yes 25 5/6 (83.3) Qi Lu and Chongdong Liu conceived of the study and participated in its design and implementation. Qi Lu and Yupeng Deng participated in the drafting of the manuscript; Yupeng Deng and Zhiqiang Zhang collected and analyzed the data; Chongdong Liu revised the manuscript critically. After the median follow-up times of 81months, six patients in radical surgery group died of their disease, and no patient in FSS died ( P = 0.035). Two patients in FIGO stage I and four patients in advanced FIGO stage died of their disease ( P = 0.086). One patient with invasive implantation and five patients without invasive implantation died of their disease ( P = 0.852). Five patients receiving chemotherapy and one patient didn’t receiving chemotherapy died of their disease ( P = 0.887). The Kaplan-Meier analysis of OS in these groups are illustrated in Fig. 2 . Discussion Swanton et al. conducted a system review included 923 BOTs patients from 19 studies, the recurrence rate in the system review was 16% [ 5 ]. In other literature, the recurrence rate of BOTs was 19% [ 6 ]. Alvarez et al. reported that the recurrence rate of BOTs was 12%-58% [ 7 ]. In this study, a total of 21 patients relapsed and the recurrence rate of BOTs patients was 12.4%, which was consistent with the literature reports. Through retrospective analysis, we found some recurrence factors, although our results do not completely confirm previous studies data. We found that FIGO stage, invasive implantation and chemotherapy were risk factors for recurrence of BOTs ( P ༜0.05). Many studies have demonstrated that higher FIGO stages are always accompanied by worse prognosis. While only 5% of patients initially diagnosed in FIGO stage I are confronted with relapse of the disease, patients with extended disease are faced with recurrence in up to 25% of cases [ 8 – 9 ]. Seong SJ et al. [ 10 ] reported that the 5-year survival for FIGO stage I BOT patients was approximately 95–97%, while stage II-III BOTs patients was only 65–87%. In the analysis of this study, the recurrence rate of FIGO stage I was 8.7% and FIGO stage II-III was 24.4% ( P = 0.035). The DFS between FIGO stage I group and FIGO stage II–III group had significant difference ( P = 0.021). However, the 5-year survival for FIGO stage I BOT patients was 95.2%, while stage II-III BOTs patients was 93.8% ( P = 0.086). Invasive implantation was one risk factor for the recurrence of BOTs in this study. Alvarez et al. showed the recurrence rate is higher in patients with invasive implantation [ 7 ]. Shih et al. also demonstrated that the presence of invasive implantation was the independent risk factors for the recurrence of BOTs [ 11 ]. Research have shown that the most important predictors of recurrence were the FIGO stage and the presence of invasive implantation [ 12 ]. In this study, the recurrence rate of patients with invasive implantation was 40% and without invasive implantation was 10.7% ( P = 0.006). Through Kapan-Meier analysis, the DFS and OS were no significant difference between the two groups. In our study, chemotherapy became a risk factor for recurrence. It is possible that patients who have been received chemotherapy are those with advanced FIGO stage disease, the possibility of residual disease or invasive implants. Studies have found that these patients have a high recurrence rate. However, there is no proven benefit from chemotherapy, even in advanced disease stages or when there is presence of invasive implants. Longacre et al. Published a study of 276 patients with BOT. of 113 patients with advanced serous BOTs, 42 received chemotherapy. 71% of the patients in the chemotherapy group were still alive after a median follow-up of 126.5 months. In contrast, 87% of the patients without chemotherapy survived after 93 months of median follow-up [ 13 ]. In our study, there were 36 patients received chemotherapy after surgery. The recurrence rate was 25%, which was significantly higher than patients without chemotherapy (9.1%), however, the DFS and OS had no significant difference between these group. Previous studies showed that histology type was one of the controversial risk factors. Fang et al. [ 14 ] showed that the patients with serous borderline ovarian tumors had a higher recurrence rate (58% vs 12%, P = 0.003), and a shorter recurrence interval ( P = 0.007) than patients with mucinous tumors. Uzan et al. reported that 140 mucinous BOTs and 114 serous BOTs, 43 patients had developed at least one recurrence, 26 among patients with SBOT and 17 among patients with MBOT (P = 0.01) in the median follow-up of 45 (range 3-136) months. However, they lack clear evidence as to whether this is due to the particular natural history of this tumor or to the fact that, as MBOT are bulky tumors, a small part of a invasive carcinoma may have been misdiagnosed after the initial sampling of a large BOT [ 15 ]. Loizzi et al. observed no difference in the survival rate between different histological types [ 16 ]. Our data showed the recurrence rate was 10% in serous BOTs and was 16.2% in mucinous BOTs. There was no difference in the recurrence rate between different histological types. Many articles have reported that micropapillary pattern are always accompanied by higher recurrence rate. Shih et al. showed that of the 196 patients with borderline tumor of serous histology, those with a micropapillary pattern had a 3-year PFS of 75.9% compared with 94.3% for patients without micropapillary pattern (P༜0.001) [ 10 ]. In Silva’s study, micropapillary pattern was the only feature that was associated with a higher recurrence rate (26% vs. 4%, P = 0.008) [ 17 ]. On the controversy, Uzan et al. demonstrated that the recurrence rate was 71% in patients without micropapillary pattern and 51% in patients with micropapillary ( P = 0.1) [ 15 ]. In this study, we found that the recurrence rate was 14.9% in patients without micropapillary pattern and 10.8% in patients with micropapillary pattern. There was no difference in the recurrence rate between patients with or without micropapillary pattern. Song et al. showed that a retrospective analysis was performed on 687 patients who underwent laparoscopy (n = 312), or laparotomy (n = 375) due to BOTs. After the median 41.8 months follow-up times, 21 patients in laparoscopy group, and 24 patients in laparotomy group had recurrence, and 4 patients in the laparoscopy group and 6 patients in the laparotomy group died of the disease. The rates of recurrence-free survival and overall survival did not differ between groups [ 18 ]. In this study, we found that the recurrence rate was 14.4% in laparotomy group and 9.8% in laparoscopic group, the difference was no significant. BOTs are typically present in reproductive age women, diagnosed at the early stage, and have a favorable prognosis. Median age at diagnosis is 45 years with 34% of patients being under 40 [ 19 – 21 ]. BOTs present more frequently as a disease limited to the ovaries compared with invasive carcinoma, as was reported in a systematic review of 6362 cases that 78.9% of the patients with BOTs are diagnosed at FIGO stage I [ 22 ]. Therefore, fertility sparing surgery is the preferred choice for young patients who desire to preserve fertility. In this study, the recurrence rate of FSS was 11.7%. Others studies have the similar conclusion. Seong et al. reported that recurrence rate of BOTs patients with fertility sparing is 10–20% [ 10 ]. Qi et al also reported that the recurrence rate of BOT patients with FSS was 10.2% [ 23 ]. Through univariate analysis, we found that tumor size and tumor site were the risk factors for recurrence of patients receiving FSS. However, they do not affect the pregnancy rate. In our study, the recurrence rate of tumor size smaller than 10cm was 20.7% and of tumor size larger than 10cm was 3.2% ( P = 0.035), however, the pregnant rate of tumor size smaller than 10cm was 80% and larger than 10cm was 83.3% ( P = 0.282). Qi et al. reported that the recurrence rate was 10.3% in tumor size smaller than 10cm group and 10.1% in tumor size larger than 10cm group, the pregnant rate was 54.5% and 57.9%, respectively. The difference was not statistically significant [ 23 ]. Fang et al. showed that the recurrence rate was 40.7% in tumor size smaller than 10cm group and 29.6% in tumor size larger than 10cm group (P = 0.569) [ 14 ]. In all of these studies, tumor size smaller than 10cm seem to be more likely to recur. We speculate that it may be because small tumors are more likely to be cystectomy rather than salpingo-oophorectomy, or it may be that small tumors are less likely to be removed completely. We also found that bilateral tumor was a risk factor for recurrence. In this study, the recurrence rate of bilateral BOTs was 30% and unilateral was 8%, the difference has statistically significant ( P = 0.048), however, it didn’t affect the pregnancy rate. Some researchers reported that the 5-year RFS was 74% and 48% in patients with unilateral and bilateral tumors, respectively [ 24 ]. Fang et al. also showed that patients with bilateral tumors had a higher recurrence rate after FSS (27.9% vs 63.6%, P = 0.038). The pregnancy rate was no significant difference between the two groups [ 14 ]. Qi et al reported that there were 7.4% recurrence rate in unilateral group and 24.2% in bilateral group ( P = 0.009). The pregnancy rate was 59.6% in unilateral group and 43.7% in bilateral group, the difference was no significant( P = 0.271) [ 23 ]. Chen et al. reported that patients with bilateral tumors had a higher recurrence rate (4.7% vs 18.7%, P = 0.07) and a shorter recurrence interval (33.2months vs 23months, P = 0.00) after conservative treatment [ 25 ]. In our population, FSS includes the following surgical approach: unilateral cystectomy (UC), unilateral salpingo-oophorectomy (USO), bilateral cystectomy (BC), unilateral salpingo-oophorectomy combined with contralateral ovarian cystectomy (USO + CC). Through analysis, surgical approach did not influence recurrence or fertility. 10 patients recurred after UC with a recurrence rate of 10%, which was higher than that of 0% after USO. Compared with USO + CC, the recurrence rate of BC was lower (25% vs 33.3%). Qi et al. reported that regarding the comparison of USO with UC, 5 cases recurred after UC with a recurrence rate of 8.9%, which was higher than that of 6.5% after USO (P = 0.812). 10 cases pregnant after UC with a pregnancy rate of 66.7%, which was higher than that of 56.2% after USO (P = 0.498), but there were no significant differences between the two groups. Compared with USO + CC, the recurrence rate of BC was lower (18.7% vs 29.4%), the pregnancy rate of BC was also lower (40% vs50%), there were no significant differences between the two groups [ 23 ]. There were 106 patients with unilateral BOTs in a study, 47 patients underwent unilateral adnexectomy and 59 underwent unilateral cystectomy. The study showed that more patients relapsed in shorter time in unilateral cystectomy group, though this difference was not statistically significant (6.8% vs 2.1%, P = 0.38), and there was also no difference between these two group in pregnancy outcome [ 25 ]. Uzan et al. reported that surgery approach (laparoscopic or laparotomy) was not associate with recurrence for patients underwent FSS [ 15 , 24 ]. Chen et al. analyzed that, compared to laparotomy, laparoscopy had no disadvantage in terms of recurrence rate and pregnancy rate [ 25 ]. In this study, surgery procedure was also not associate with recurrence rate and pregnancy rate for patients underwent FSS. Qi et al. showed that the recurrence rate of laparotomy in FSS patients is higher than in laparoscopic surgery (14.3% vs 4.3%, P = 0.029). The pregnancy rate between laparotomy and laparoscopic has no significant difference (60.6% vs 50%, P = 0.397) [ 23 ]. Therefore, laparoscopy seems to be the most attractive surgical approach to BOT due to well-proven benefits such as faster recovery, lower perioperative complication rates and reduce pelvic adhesion that could possibly impair fertility. In our study, there were 13 patients received chemotherapy after FSS. The recurrence rate was 15.4% and the pregnancy rate was 75%, compared to without chemotherapy patients, the difference was not statistically significant. Fang et al. Studied 12 patients underwent chemotherapy and concluded that there was no significant difference in recurrence rate and pregnancy rate [ 14 ]. All the evidence demonstrated that the patients did not receive any benefit from chemotherapy, especially for patients underwent FSS. Chemotherapeutic agents which reach the ovaries lead to damage to the primordial follicles. The detrimental effect of cytotoxic agents on the ovary is thought to be caused by damage to peri-oocyte granulosa cells in the ovaries. Damage to ovarian tissue as a result of the use of cytotoxic agents is irreversible. Histological samples of ovarian tissue after chemotherapy have shown range of damage, from a reduction in follicle count to complete failure [ 26 ]. Therefore, chemotherapy was not recommended for patients even with advanced BOT, especially of patients who have fertility desire. There are some limitations in this study. It is a retrospective study and the nature of the study might be a source of bias. The number of included patients was limited, and the relatively small number of patients attempt to conceive might limit the statistical power of our findings. Conclusion BOTs are tumors with a favorable prognosis. After univariate and multivariate analysis, we found some risk factors for recurrence after radical surgery, but they don’t affect the overall survival rate. FSS is a feasible approach for young patients. Although tumor size and tumor site are risk factors for recurrence, they do not affect long-term survival and pregnancy rate. Laparoscopy procedure is recommended and chemotherapy is not recommended for patients receiving FSS. We suggest that patients who preserve fertility should get pregnant as soon as possible and follow up closely. Declarations Ethics approval and consent to participate Not applicable. Because this study was a retrospective study, the ethics approval and consent to participate were waived by the Medical Ethics Committee of Beijing Chaoyang Hospital. All procedures performed in this study involving human participants were in accordance with the ethical standards of the1964 Helsinki declaration and its later amendments. Consent for publication Not applicable. No details on individual patients have been reported in this study. Availability of data and materials The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. Competing interests All the authors declare that they have no conflict of interests. Funding Not applicable. Authors’ contribution Qi Lu and Chongdong Liu conceived of the study and participated in its design and implementation. Qi Lu and Yupeng Deng participated in the drafting of the manuscript; Yupeng Deng and Zhiqiang Zhang collected and analyzed the data; Chongdong Liu revised the manuscript critically. Acknowledgements We thank Dr. Zhenyu Zhang for his help in this manuscript. References Ouldamer L (2016) Is there a justification for hysterectomy in patients with borderline ovarian tumors? Surg Oncol 25:1–5 William R (2005) Hart Borderline epithelial tumors of the ovary. Mod Pathol 18:S33–S50 Bourdel N (2021) Borderline ovarian tumors: French guidelines from the CNGOF. Part 2. Surgical management, follow-up, hormone replacement therapy, fertility management and preservation. J Gynecol Obstet Hum Reprod 50:101966 Skírnisdóttir I, Garmo H, Wilander E, Holmberg L (2008) Borderline ovarian tumors in Sweden 1960–2005: trends in incidence and age at diagnosis compared to ovarian cancer. Int J Cancer 123:1897–1901 Swanton A, Bankhead CR, Kehoe S (2007) Pregnancy rate after conservative treatment for borderline ovarian tumoours: a systematic review. Eur J Obstet Gynecol Reprod Biol 135:3–7 Candotti G, Peiretti M, Mangili G, Bergamini A, Candiani M, Cioffi R, Mais V, Rabaiotti E, Bocciolone L (2020) What women want: Fertility sparing surgery in Borderline ovarian tumours patients and pregnancy outcome. Eur J Surg Oncol 46:888–892 Alvarez RM, Vazquez-Vicente D (2015) Fertility sparing treatment in borderline ovarian tumours. Ecancermedical Sci 9:507 Lenhard MS, Mitterer S, Kumper C et al (2009) Long-term follow-up after ovarian borderline tumor: relapse and survival in a large patient cohort. Eur J OBstet Gynecol Reprod Biol 145:189–194 Renn J, Peng Z, Yang K (2008) A clinicopathologic multivariate analysis affecting recurrence of borderline ovarian tumors. Gyneco Oncol 110:162–167 Seong SJ, Kim DH, Kim MK, Song T (2015) Controversies in borderline ovarian tumors. J Gynecol Oncol 26:343–349 Shih KK, Zhou Q, Huh J et al (2011) Risk factors for recurrence of ovarian borderline tumors. Gynecol Oncol 120:480–484 Rasmussen ELK, Hannibal CG, Dehlendorff C, Baandrup L, Junge J, Vang R, Kurman RJ, Kjaer SK (2017) Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study. Gynecol Oncol 144:571–576 Longacre TA, McKenney JK, Tazelaar HD, Kempson RL, Hendrickson MR (2005) Ovarian serous tumors of low malignant potential (borderline tumors): outcome-based study of 276 patients with long-term (> or = 5-year) follow-up. Am J Surg Pathol 29:707–723 Fang C, Zhao L, Chen X, Yu A, Xia L, Zhang P (2018) The impact of clinicopathologic and surgical factors on relapse and pregnancy in young patients (≤ 40 years old) with borderline ovarian tumors. BMC Cancer 18:1147 Uzan C, Nikpayam M, Ribassin-Majed L, Gouy S, Bendifallah S, Cortez A, Rey A, Duvillard P, Darai E, Morice P (2014) Influence of histological subtypes on the risk of an invasive recurrence in a large series of stage I borderline ovarian tumor including 191 conservative treatments. Ann Oncol 25:1312–1319 Loizzi V, Selvaggi L, Leone L, Latorre D, Scardigno D, Magazzino F, Cormio G (2015) Borderline epithelial tumors of the ovary: Experience of 55 patients. Oncol Lett 9:912–914 Silva EG, Gershenson DM, Malpica A, Deavers M (2006) The recurrence and the overall survival rates of ovarian serous borderline neoplasms with noninvasive implants is time dependent. Am J Surg Pathol 30:1367–1371 Song T, Kim MK, Jung YW, Yun BS, Seong SJ, Choi CH, Kim TJ, Lee JW, Bae DS, Kim BG (2017) Minimally invasive compared with open surgery in patients with borderline ovarian tumors. Gynecol Oncol 145:508–512 Sherman ME, Berman J, Birrer MJ, Cho KR, Ellenson LH, Gorstein F, Seidman JD (2004) Current challenges and opportunities for research on borderline ovarian tumors. Hum Pathol 35:961–970 Sherman ME, Mink PJ, Curtis R, Cote TR, Brooks S, Hartge P, Devesa S (2004) Survival among women with borderline ovarian tumors and ovarian carcinoma: a population-based analysis. Cancer 100:1045–1052 Trimble CL, Kosary C, Trimble EL (2002) Long-term survival and patterns of care in women with ovarian tumors of low malignant potential. Gynecol Oncol 86:34–37 du Bois A, Trillsch F, Mahner S, Heitz F, Harter P (2016) Management of borderline ovarian tumors. Ann Oncol 27:i20–i22 Qi Y, Wang M, Yang Y, Zeng Z, Zhou Y (2021) Analysis of Factors Influencing Relapse and Pregnancy in Patients with Borderline Ovarian Tumors. J Cancer 12:5275–5285 Uzan C, Muller E, Kane A, Rey A, Gouy S, Bendiffallah S, Duvillard P, Fauvet R, Darai E, Morice P (2014) Prognostic factors for recurrence after conservative treatment in a series of 119 patients with stage I serous borderline tumors of the ovary. Ann Oncol 25:166–171 Chen RF, Li J, Zhu TT, Yu HL, Lu X (2016) Fertility-sparing surgery for young patients with borderline ovarian tumors (BOTs): single institution experience. J Ovarian Res 9:16 Warne GL, Fairley KF, Hobbs JB et al (1973) Cyclophosphamide induced ovarian failure. N Engl J Med 289:1159 Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1448580","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":139705014,"identity":"21c89463-1652-44d7-baa6-81c893c1334b","order_by":0,"name":"Qi Lu","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qi","middleName":"","lastName":"Lu","suffix":""},{"id":139705015,"identity":"64c35467-bf0f-4e0d-b1dd-85d109311b45","order_by":1,"name":"Yupeng Deng","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yupeng","middleName":"","lastName":"Deng","suffix":""},{"id":139705016,"identity":"57a1303b-b3db-4e8a-a46c-09b7d6761f46","order_by":2,"name":"Zhiqiang Zhang","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhiqiang","middleName":"","lastName":"Zhang","suffix":""},{"id":139705017,"identity":"e6cea96e-2310-4990-a43a-1ff88628fa99","order_by":3,"name":"chongdong liu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIiWNgGAWjYBACPmYGBmYw6wAQfzCQ4OFnZj78AJ8WNmQtjDMqbOQk29nSDPBqYUDSwsxzJs3Y4DyPggReLew8hp8LKu7Y9R3vPfyCt+1w4ubDPAwGDDU20bgdxmMsPePMs+SZZ86lWUgCtWw7zHvgAcOxtNwG3FrMmIGGJxvcyDEzMARr4UswYGw4TKSWRJDDmnkMJIjRYgfUYvzgAMj7zAS1sBVL85w5nCB55owZYwMwkCUOAwM5AY9f+PkPb/zMU3HYnu94j/HnP6Co7D98+MGHGhucWmAgEaiADREdCQSUg4A9EDN/IELhKBgFo2AUjEAAALRZWa7zS9AFAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0002-0324-7645","institution":"Beijing Chaoyang Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"chongdong","middleName":"","lastName":"liu","suffix":""}],"badges":[],"createdAt":"2022-03-14 05:44:05","currentVersionCode":2,"declarations":"","doi":"10.21203/rs.3.rs-1448580/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-1448580/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":27035315,"identity":"f371a420-4a9c-4c78-824a-4fcceb035c74","added_by":"auto","created_at":"2022-09-27 15:12:28","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":230105,"visible":true,"origin":"","legend":"\u003cp\u003eDisease-free survival curves (DFS) for different clinicopathologic factors. \u003cstrong\u003eA\u003c/strong\u003e comparison of DFS curves between FIGO stage I and advanced stage BOTs. \u003cstrong\u003eB \u003c/strong\u003ecomparison of DFS curves between patients with invasive implantation and patients without invasive implantation. \u003cstrong\u003eC \u003c/strong\u003ecomparison of DFS curves between patients with chemotherapy and without chemotherapy.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-1448580/v2/ef08bba49eac43cfddfa58dd.png"},{"id":27035317,"identity":"45707ea9-135e-43d3-9aae-fe1064a90298","added_by":"auto","created_at":"2022-09-27 15:12:29","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":227578,"visible":true,"origin":"","legend":"\u003cp\u003eOverall survival curves (OS) for different clinicopathologic factors. \u003cstrong\u003eA \u003c/strong\u003ecomparison of OS curves between patietns with FSS and patients without FSS. \u003cstrong\u003eB\u003c/strong\u003e comparison of OS curves between FIGO stage I and advanced stage BOTs. \u003cstrong\u003eC \u003c/strong\u003ecomparison of OS curves between patients with invasive implantation and patients without invasive implantation. \u003cstrong\u003eD \u003c/strong\u003ecomparison of OS curves between patients with chemotherapy and without chemotherapy.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-1448580/v2/012ec71b8486afe5c5df0be6.png"},{"id":30282336,"identity":"45326548-f18a-4d52-b887-1b9ef7eaf30f","added_by":"auto","created_at":"2022-12-13 20:20:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":748479,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1448580/v2/570792c9-526f-43ee-acab-83bd1d4cb2f6.pdf"}],"financialInterests":"","formattedTitle":"Risk factors of recurrence and pregnancy in patients with borderline ovarian tumors: a retrospective study with 16-year follow-up","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBorderline ovarian tumors (BOTs), first described by Taylor in 1929, account for 10% -20% of epithelial ovarian tumors. BOTs are characterized by atypical epithelial proliferation without stromal invasion. Its histopathology and biological behavior are between benign and malignant tumors [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. BOTs of every surface epithelial cell type (serous, mucinous, endometrioid, clear cell, transitional cell and mixed epithelial cell) have now been reported. However, the serous and mucinous BOTs are the most common by far [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. It was estimated that about 2.5 to 5.5 per 100,000 women were diagnosed as BOTs every year. BOTs of all stages combined have favorable 5-year and 10-year survival rates of 95% and 90%, respectively [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The recommended treatment for BOTs consists of peritoneal washing, hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies. Appendectomy is also recommended for women with mucinous BOTs. Compared with malignant tumors, BOTs are more frequently diagnosed in young women of childbearing age, and approximately one-third of them are diagnosed before 40 years of age [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. For the past ten years, with the implementation of the two-child policy in China and delay in childbearing age, fertility sparing surgery (FSS) is widely accepted for treatment of BOTs. So far, the main issue of BOTs is that there is still no consensus on the risk factors for recurrence and pregnancy. Therefore, the purpose of this study was to analyze the influencing factors for recurrence of BOTs and evaluate the efficacy of FSS in terms of fertility outcomes.\u003c/p\u003e"},{"header":"Materials And Methods","content":"\u003cp\u003eConsecutive patients were diagnosed as BOTs in Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2005 to November 2021 were screened for inclusion in the analysis. Inclusion criteria: 1) Patients with initial treatment and operation in Beijing Chaoyang Hospital affiliated to Capital Medical University. 2) Patients with BOTs that were confirmed by pathology; 3) patients\u0026rsquo; diagnoses were based on the World Health Organization (WHO) pathological diagnosis standard of BOTs; 4) patients with complete clinical data and follow-up data. Exclusion criteria: 1) Patients complicated with gynecological malignant tumors; 2) Patients have a history of other malignant tumor; 3) Patients complicated with severe heart, lung, liver, kidney dysfunction; 4) patients without complete clinical data and follow-up data.\u003c/p\u003e \u003cp\u003eThe clinical pathological data concerned age, history of fertility, menopause, chief complaint, tumor size, tumor site, pathology, micropapillary pattern, invasive implantation, surgical approach, surgery with or without fertility preserving, lymphadenectomy, omentectomy, FIGO stage (2014 FIGO classification system), preoperative CA125.\u003c/p\u003e\n\u003ch2\u003eTreatment\u003c/h2\u003e\u003cp\u003eSurgery without fertility preserving consists of peritoneal washing, hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies. Appendectomy was performed for patients with mucinous BOTs. Fertility sparing surgery was defined as the preservation of the uterus and at least part of one ovary. It includes the following surgical methods: unilateral cystectomy (UC), unilateral salpingo-oophorectomy (USO), bilateral cystectomy (BC), unilateral salpingo-oophorectomy combined with contralateral ovarian cystectomy (USO\u0026thinsp;+\u0026thinsp;CC). There is no evidence supporting lymph node dissection in borderline ovarian tumors. Adjuvant treatment is not accepted for the standard care of BOT patients. The indications of chemotherapy or radiotherapy depended on the pathological results, the possibility of residual disease, and invasive peritoneal implants.\u003c/p\u003e\n\u003ch2\u003eFollow-up\u003c/h2\u003e\u003cp\u003ePatient follow-up consisted of physical and gynecological examinations, CA-125, and ultrasound scan every 3 months during the first 2 years and every 6 months afterwards. Disease-free survival (DFS) defined as the duration from primary surgery to the first recurrence or the last visit. Overall survival (OS) defined as the duration from primary surgery to death or the last visit.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eData were statistically analyzed using SPSS 25.0 statistical software. The comparison between groups was performed by t-test. The adoption rate of counting data was expressed by chi-square test and Fisher exact probability method. The variables with statistically significant differences in univariate analysis were included in the COX regression model for multivariate analysis. DFS and OS were assessed using the Kaplan-Meier method, whereas statistically significant difference was examined by log rank test. The difference is statistically significant at P༜0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 169 BOT patients from January of 2005 to November of 2021 in Beijing Chaoyang hospital were included in the study. The median age was 45 years (range, 14\u0026ndash;88 years), and 49 patients (29%) had not history of fertility. Median follow-up time was 81months (1-203months). The characteristics of patients are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Majority of patients (54.4%) found the disease by physical examination, then abdominal pain. 55% patients\u0026rsquo; tumors diameter of BOTs were larger than 10 cm and 81.7% were unilateral. The most common pathology type was serous (48.5%), then mucinous (43.8%). 57.4% patients underwent laparoscopic surgery. There were 127 patients diagnosed at early stage.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinicopathological and biological data of BOT patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003echaracteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian age (min, max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45 (14\u0026ndash;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of fertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMenopause\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChief complaint\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbdominal pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTouching mass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical examination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor size (cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e༜10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor site\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCA125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e༞35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrozen section diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBenign\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorderline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOvarian tumor rupture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpontaneous rupture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative rupture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMucinous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eothers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMicropapillary pattern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvasive implantation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical approach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparotomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparoscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphadenectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOmentectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFertility-sparing surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFIGO stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChemotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvolvement ovary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReserved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExcision\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Staging surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA total of 21 patients relapsed, with a recurrence rate of 12.4%. The shortest interval of recurrence was 2 months and the longest was 148 months. The median recurrence interval was 62 months. Through univariate analysis, we found that FIGO stage, invasive implantation and chemotherapy affected BOT recurrence, and the differences were statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The recurrence rate of FIGO stage I was 8.7% and FIGO stage II and III was 24.4%. The recurrence rate of the patients with invasive implantation was 40% and patients without invasive implantation was 10.8%. The recurrence rate of patients receiving chemotherapy was 25% and not receiving chemotherapy was 9%. The survival curves of patients in these groups are provided in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Univariate analysis of factors affecting recurrence are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Through multivariate analysis, we found that FIGO stage was only one independent risk factor affecting BOT recurrence rate (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.039).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis of factors affecting recurrence in patients with BOT\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003echaracteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo recurrence (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRecurrence (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian age (min, max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of fertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43 (87.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (12.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.964\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e105 (87.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMenopause\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.982\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92 (87.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (12.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56 (87.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor size (cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.794\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e༜10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66 (86.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (13.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82 (88.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor site\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.196\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e123 (89.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (10.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (80.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (19.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCA125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.691\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (88.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e༞35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84 (86.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (8.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrozen section diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.559\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBenign\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (89.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorderline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89 (85.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (14.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (93.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOvarian tumor rupture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.438\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e123 (88.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (11.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.225\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73 (89.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (11.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMucinous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (83.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (16.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eothers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMicropapillary pattern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.466\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65 (85.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e83 (89.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvasive implantation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e142 (89.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical approach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.359\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparotomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e83 (85.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (14.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparoscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65 (90.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (9.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphadenectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.133\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59 (83.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (16.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89 (90.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOmentectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.460\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (90.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101 (86.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (13.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFertility-sparing surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.824\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95 (87.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (88.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (11.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFIGO stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e116 (91.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (76.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (23.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChemotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121 (90.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvolvement ovary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.590\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReserved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (92.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (7.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExcision\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136 (87.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Staging surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.838\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (86.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95 (88.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn this study, 60 patients underwent fertility sparing surgery. The median age was 28 years (range, 14\u0026ndash;46 years). There were 40 patients undergoing USO, 10 patients undergoing UC, 4 patients receiving BC and 6 patients receiving USO\u0026thinsp;+\u0026thinsp;CC. The recurrence rates of these patients were 10%, 0%, 25% and 33.3% respectively, indicating that the groups showed no statistically significant difference. The recurrence rate of laparoscopic group was 15% and of laparotomy was 10%, but the differences were not statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.570). The recurrence rate of patients with tumor size smaller than 10cm was 20.7%, and tumor size larger than 10cm was 3.2%, the difference has statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.035). The recurrence rate of patients with unilateral tumor was 8% and with bilateral tumors was 30% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.048). Univariate analysis of factors affecting recurrence in BOT patients with FSS are shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis of factors affecting recurrence in BOT patients with FSS\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003echaracteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo recurrence (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRecurrence (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (88.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (11.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian age (min, max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (14\u0026ndash;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (24\u0026ndash;36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.929\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of fertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.704\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34 (87.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (90.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor size (cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e༜10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (79.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (20.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (96.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor site\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46 (92.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCA125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.336\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e༞35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (95.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrozen section diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.564\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBenign\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorderline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (87.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (12.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOvarian tumor rupture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.512\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpontaneous rupture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative rupture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.737\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (88.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (11.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMucinous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26 (86.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eothers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMicropapillary pattern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.795\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (89.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (87.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (12.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvasive implantation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.711\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51 (87.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (12.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical approach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.570\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparotomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparoscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphadenectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (80.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (19.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (96.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOmentectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.903\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (88.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (87.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (12.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFertility-sparing surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUSO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.297\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.778\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUSO\u0026thinsp;+\u0026thinsp;CC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFIGO stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.082\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (91.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (8.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e≧ II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChemotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.657\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (89.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (84.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (15.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvolvement ovary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.547\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReserved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (92.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExcision\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40 (87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Staging surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.228\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (93.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBecause of some reasons, only 16 patients still had fertility desire after operation. Among them, 13 patients have successfully conceived spontaneously and all of them had term live births. The pregnancy rate was 81.3%. There were no serious complications in obstetric and neonatal outcomes among women with live births. No tumor recurrence happened during pregnancy. The pregnancy rates in these patients receiving USO, UC, BC or USO\u0026thinsp;+\u0026thinsp;CC were 88.9%, 66.7%, 50% and 100% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.899) respectively. The pregnancy rates in FIGO stage I and advanced FIGO stage were 81.1% and 80% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.148). The pregnancy rate of patients underwent chemotherapy was 75%, which lower than patients without chemotherapy (83.3%), however, the difference was not statistically significant. The pregnancy rate in laparoscopic group was 100% and in laparotomy group was 75% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.825). The pregnancy rates in patient with lymphadenectomy or without lymphadenectomy were 80% and 81.8%, respectively. Through univariate and multivariate analysis, no factor was found to be significantly correlated with pregnancy rate. (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis of pregnancy factors in BOT patients with FSS\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003echaracteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-pregnancy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN patients achieving/\u003c/p\u003e \u003cp\u003eattempting pregnancy (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13/16 (81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian age (min, max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28(20\u0026ndash;36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.309\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of fertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11/13 (84.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.094\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2/3 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor size (cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e༜10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8/10 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.282\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5/6 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCA125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2/4 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.420\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e༞35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6/7 (85.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5/5 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7/10 (70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.640\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMucinous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5/5 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eothers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1/1 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMicropapillary pattern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7/9 (77.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.601\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6/7 (85.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvasive implantation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13/15 (86.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.592\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0/1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical approach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparotomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9/12 (75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.825\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaparoscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4/4 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphadenectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9/11 (81.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.152\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4/5 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOmentectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7/10 (70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.469\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6/6 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFertility-sparing surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUSO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8/9 (88.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.899\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2/3 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1/2 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUSO\u0026thinsp;+\u0026thinsp;CC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2/2 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFIGO stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9/11 (81.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.148\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eII\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4/5 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChemotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10/12 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.889\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3/4 (75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete Staging surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8/10 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.347\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5/6 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eQi Lu and Chongdong Liu conceived of the study and participated in its design and implementation. Qi Lu and Yupeng Deng participated in the drafting of the manuscript; Yupeng Deng and Zhiqiang Zhang collected and analyzed the data; Chongdong Liu revised the manuscript critically.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAfter the median follow-up times of 81months, six patients in radical surgery group died of their disease, and no patient in FSS died (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.035). Two patients in FIGO stage I and four patients in advanced FIGO stage died of their disease (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.086). One patient with invasive implantation and five patients without invasive implantation died of their disease (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.852). Five patients receiving chemotherapy and one patient didn\u0026rsquo;t receiving chemotherapy died of their disease (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.887). The Kaplan-Meier analysis of OS in these groups are illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eSwanton et al. conducted a system review included 923 BOTs patients from 19 studies, the recurrence rate in the system review was 16% [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In other literature, the recurrence rate of BOTs was 19% [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Alvarez et al. reported that the recurrence rate of BOTs was 12%-58% [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In this study, a total of 21 patients relapsed and the recurrence rate of BOTs patients was 12.4%, which was consistent with the literature reports.\u003c/p\u003e \u003cp\u003eThrough retrospective analysis, we found some recurrence factors, although our results do not completely confirm previous studies data. We found that FIGO stage, invasive implantation and chemotherapy were risk factors for recurrence of BOTs (\u003cem\u003eP\u003c/em\u003e༜0.05). Many studies have demonstrated that higher FIGO stages are always accompanied by worse prognosis. While only 5% of patients initially diagnosed in FIGO stage I are confronted with relapse of the disease, patients with extended disease are faced with recurrence in up to 25% of cases [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Seong SJ et al. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] reported that the 5-year survival for FIGO stage I BOT patients was approximately 95\u0026ndash;97%, while stage II-III BOTs patients was only 65\u0026ndash;87%. In the analysis of this study, the recurrence rate of FIGO stage I was 8.7% and FIGO stage II-III was 24.4% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.035). The DFS between FIGO stage I group and FIGO stage II\u0026ndash;III group had significant difference (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.021). However, the 5-year survival for FIGO stage I BOT patients was 95.2%, while stage II-III BOTs patients was 93.8% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.086). Invasive implantation was one risk factor for the recurrence of BOTs in this study. Alvarez et al. showed the recurrence rate is higher in patients with invasive implantation [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Shih et al. also demonstrated that the presence of invasive implantation was the independent risk factors for the recurrence of BOTs [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Research have shown that the most important predictors of recurrence were the FIGO stage and the presence of invasive implantation [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In this study, the recurrence rate of patients with invasive implantation was 40% and without invasive implantation was 10.7% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.006). Through Kapan-Meier analysis, the DFS and OS were no significant difference between the two groups. In our study, chemotherapy became a risk factor for recurrence. It is possible that patients who have been received chemotherapy are those with advanced FIGO stage disease, the possibility of residual disease or invasive implants. Studies have found that these patients have a high recurrence rate. However, there is no proven benefit from chemotherapy, even in advanced disease stages or when there is presence of invasive implants. Longacre et al. Published a study of 276 patients with BOT. of 113 patients with advanced serous BOTs, 42 received chemotherapy. 71% of the patients in the chemotherapy group were still alive after a median follow-up of 126.5 months. In contrast, 87% of the patients without chemotherapy survived after 93 months of median follow-up [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In our study, there were 36 patients received chemotherapy after surgery. The recurrence rate was 25%, which was significantly higher than patients without chemotherapy (9.1%), however, the DFS and OS had no significant difference between these group.\u003c/p\u003e \u003cp\u003ePrevious studies showed that histology type was one of the controversial risk factors. Fang et al. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] showed that the patients with serous borderline ovarian tumors had a higher recurrence rate (58% vs 12%, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003), and a shorter recurrence interval (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.007) than patients with mucinous tumors. Uzan et al. reported that 140 mucinous BOTs and 114 serous BOTs, 43 patients had developed at least one recurrence, 26 among patients with SBOT and 17 among patients with MBOT (P\u0026thinsp;=\u0026thinsp;0.01) in the median follow-up of 45 (range 3-136) months. However, they lack clear evidence as to whether this is due to the particular natural history of this tumor or to the fact that, as MBOT are bulky tumors, a small part of a invasive carcinoma may have been misdiagnosed after the initial sampling of a large BOT [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Loizzi et al. observed no difference in the survival rate between different histological types [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Our data showed the recurrence rate was 10% in serous BOTs and was 16.2% in mucinous BOTs. There was no difference in the recurrence rate between different histological types. Many articles have reported that micropapillary pattern are always accompanied by higher recurrence rate. Shih et al. showed that of the 196 patients with borderline tumor of serous histology, those with a micropapillary pattern had a 3-year PFS of 75.9% compared with 94.3% for patients without micropapillary pattern (P༜0.001) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In Silva\u0026rsquo;s study, micropapillary pattern was the only feature that was associated with a higher recurrence rate (26% vs. 4%, P\u0026thinsp;=\u0026thinsp;0.008) [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. On the controversy, Uzan et al. demonstrated that the recurrence rate was 71% in patients without micropapillary pattern and 51% in patients with micropapillary (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.1) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In this study, we found that the recurrence rate was 14.9% in patients without micropapillary pattern and 10.8% in patients with micropapillary pattern. There was no difference in the recurrence rate between patients with or without micropapillary pattern. Song et al. showed that a retrospective analysis was performed on 687 patients who underwent laparoscopy (n\u0026thinsp;=\u0026thinsp;312), or laparotomy (n\u0026thinsp;=\u0026thinsp;375) due to BOTs. After the median 41.8 months follow-up times, 21 patients in laparoscopy group, and 24 patients in laparotomy group had recurrence, and 4 patients in the laparoscopy group and 6 patients in the laparotomy group died of the disease. The rates of recurrence-free survival and overall survival did not differ between groups [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In this study, we found that the recurrence rate was 14.4% in laparotomy group and 9.8% in laparoscopic group, the difference was no significant.\u003c/p\u003e \u003cp\u003eBOTs are typically present in reproductive age women, diagnosed at the early stage, and have a favorable prognosis. Median age at diagnosis is 45 years with 34% of patients being under 40 [\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. BOTs present more frequently as a disease limited to the ovaries compared with invasive carcinoma, as was reported in a systematic review of 6362 cases that 78.9% of the patients with BOTs are diagnosed at FIGO stage I [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Therefore, fertility sparing surgery is the preferred choice for young patients who desire to preserve fertility. In this study, the recurrence rate of FSS was 11.7%. Others studies have the similar conclusion. Seong et al. reported that recurrence rate of BOTs patients with fertility sparing is 10\u0026ndash;20% [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Qi et al also reported that the recurrence rate of BOT patients with FSS was 10.2% [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThrough univariate analysis, we found that tumor size and tumor site were the risk factors for recurrence of patients receiving FSS. However, they do not affect the pregnancy rate. In our study, the recurrence rate of tumor size smaller than 10cm was 20.7% and of tumor size larger than 10cm was 3.2% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.035), however, the pregnant rate of tumor size smaller than 10cm was 80% and larger than 10cm was 83.3% (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.282). Qi et al. reported that the recurrence rate was 10.3% in tumor size smaller than 10cm group and 10.1% in tumor size larger than 10cm group, the pregnant rate was 54.5% and 57.9%, respectively. The difference was not statistically significant [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Fang et al. showed that the recurrence rate was 40.7% in tumor size smaller than 10cm group and 29.6% in tumor size larger than 10cm group (P\u0026thinsp;=\u0026thinsp;0.569) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In all of these studies, tumor size smaller than 10cm seem to be more likely to recur. We speculate that it may be because small tumors are more likely to be cystectomy rather than salpingo-oophorectomy, or it may be that small tumors are less likely to be removed completely. We also found that bilateral tumor was a risk factor for recurrence. In this study, the recurrence rate of bilateral BOTs was 30% and unilateral was 8%, the difference has statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.048), however, it didn\u0026rsquo;t affect the pregnancy rate. Some researchers reported that the 5-year RFS was 74% and 48% in patients with unilateral and bilateral tumors, respectively [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Fang et al. also showed that patients with bilateral tumors had a higher recurrence rate after FSS (27.9% vs 63.6%, P\u0026thinsp;=\u0026thinsp;0.038). The pregnancy rate was no significant difference between the two groups [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Qi et al reported that there were 7.4% recurrence rate in unilateral group and 24.2% in bilateral group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.009). The pregnancy rate was 59.6% in unilateral group and 43.7% in bilateral group, the difference was no significant(\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.271) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Chen et al. reported that patients with bilateral tumors had a higher recurrence rate (4.7% vs 18.7%, P\u0026thinsp;=\u0026thinsp;0.07) and a shorter recurrence interval (33.2months vs 23months, P\u0026thinsp;=\u0026thinsp;0.00) after conservative treatment [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our population, FSS includes the following surgical approach: unilateral cystectomy (UC), unilateral salpingo-oophorectomy (USO), bilateral cystectomy (BC), unilateral salpingo-oophorectomy combined with contralateral ovarian cystectomy (USO\u0026thinsp;+\u0026thinsp;CC). Through analysis, surgical approach did not influence recurrence or fertility. 10 patients recurred after UC with a recurrence rate of 10%, which was higher than that of 0% after USO. Compared with USO\u0026thinsp;+\u0026thinsp;CC, the recurrence rate of BC was lower (25% vs 33.3%). Qi et al. reported that regarding the comparison of USO with UC, 5 cases recurred after UC with a recurrence rate of 8.9%, which was higher than that of 6.5% after USO (P\u0026thinsp;=\u0026thinsp;0.812). 10 cases pregnant after UC with a pregnancy rate of 66.7%, which was higher than that of 56.2% after USO (P\u0026thinsp;=\u0026thinsp;0.498), but there were no significant differences between the two groups. Compared with USO\u0026thinsp;+\u0026thinsp;CC, the recurrence rate of BC was lower (18.7% vs 29.4%), the pregnancy rate of BC was also lower (40% vs50%), there were no significant differences between the two groups [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. There were 106 patients with unilateral BOTs in a study, 47 patients underwent unilateral adnexectomy and 59 underwent unilateral cystectomy. The study showed that more patients relapsed in shorter time in unilateral cystectomy group, though this difference was not statistically significant (6.8% vs 2.1%, P\u0026thinsp;=\u0026thinsp;0.38), and there was also no difference between these two group in pregnancy outcome [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUzan et al. reported that surgery approach (laparoscopic or laparotomy) was not associate with recurrence for patients underwent FSS [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Chen et al. analyzed that, compared to laparotomy, laparoscopy had no disadvantage in terms of recurrence rate and pregnancy rate [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In this study, surgery procedure was also not associate with recurrence rate and pregnancy rate for patients underwent FSS. Qi et al. showed that the recurrence rate of laparotomy in FSS patients is higher than in laparoscopic surgery (14.3% vs 4.3%, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.029). The pregnancy rate between laparotomy and laparoscopic has no significant difference (60.6% vs 50%, P\u0026thinsp;=\u0026thinsp;0.397) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Therefore, laparoscopy seems to be the most attractive surgical approach to BOT due to well-proven benefits such as faster recovery, lower perioperative complication rates and reduce pelvic adhesion that could possibly impair fertility.\u003c/p\u003e \u003cp\u003eIn our study, there were 13 patients received chemotherapy after FSS. The recurrence rate was 15.4% and the pregnancy rate was 75%, compared to without chemotherapy patients, the difference was not statistically significant. Fang et al. Studied 12 patients underwent chemotherapy and concluded that there was no significant difference in recurrence rate and pregnancy rate [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. All the evidence demonstrated that the patients did not receive any benefit from chemotherapy, especially for patients underwent FSS. Chemotherapeutic agents which reach the ovaries lead to damage to the primordial follicles. The detrimental effect of cytotoxic agents on the ovary is thought to be caused by damage to peri-oocyte granulosa cells in the ovaries. Damage to ovarian tissue as a result of the use of cytotoxic agents is irreversible. Histological samples of ovarian tissue after chemotherapy have shown range of damage, from a reduction in follicle count to complete failure [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Therefore, chemotherapy was not recommended for patients even with advanced BOT, especially of patients who have fertility desire.\u003c/p\u003e \u003cp\u003eThere are some limitations in this study. It is a retrospective study and the nature of the study might be a source of bias. The number of included patients was limited, and the relatively small number of patients attempt to conceive might limit the statistical power of our findings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eBOTs are tumors with a favorable prognosis. After univariate and multivariate analysis, we found some risk factors for recurrence after radical surgery, but they don\u0026rsquo;t affect the overall survival rate. FSS is a feasible approach for young patients. Although tumor size and tumor site are risk factors for recurrence, they do not affect long-term survival and pregnancy rate. Laparoscopy procedure is recommended and chemotherapy is not recommended for patients receiving FSS. We suggest that patients who preserve fertility should get pregnant as soon as possible and follow up closely.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. Because this study was a retrospective study, the ethics approval and consent to participate were waived by the Medical Ethics Committee of Beijing Chaoyang Hospital. All procedures performed in this study involving human participants were in accordance with the ethical standards of the1964 Helsinki declaration and its later amendments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. No details on individual patients have been reported in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the authors declare that they have no conflict of interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQi Lu and Chongdong Liu conceived of the study and participated in its design and implementation. Qi Lu and Yupeng Deng participated in the drafting of the manuscript; Yupeng Deng and Zhiqiang Zhang collected and analyzed the data; Chongdong Liu revised the manuscript critically.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank Dr. Zhenyu Zhang for his help in this manuscript.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOuldamer L (2016) Is there a justification for hysterectomy in patients with borderline ovarian tumors? Surg Oncol 25:1\u0026ndash;5\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilliam R (2005) Hart Borderline epithelial tumors of the ovary. Mod Pathol 18:S33\u0026ndash;S50\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBourdel N (2021) Borderline ovarian tumors: French guidelines from the CNGOF. Part 2. Surgical management, follow-up, hormone replacement therapy, fertility management and preservation. J Gynecol Obstet Hum Reprod 50:101966\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSk\u0026iacute;rnisd\u0026oacute;ttir I, Garmo H, Wilander E, Holmberg L (2008) Borderline ovarian tumors in Sweden 1960\u0026ndash;2005: trends in incidence and age at diagnosis compared to ovarian cancer. Int J Cancer 123:1897\u0026ndash;1901\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSwanton A, Bankhead CR, Kehoe S (2007) Pregnancy rate after conservative treatment for borderline ovarian tumoours: a systematic review. Eur J Obstet Gynecol Reprod Biol 135:3\u0026ndash;7\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCandotti G, Peiretti M, Mangili G, Bergamini A, Candiani M, Cioffi R, Mais V, Rabaiotti E, Bocciolone L (2020) What women want: Fertility sparing surgery in Borderline ovarian tumours patients and pregnancy outcome. Eur J Surg Oncol 46:888\u0026ndash;892\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlvarez RM, Vazquez-Vicente D (2015) Fertility sparing treatment in borderline ovarian tumours. Ecancermedical Sci 9:507\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLenhard MS, Mitterer S, Kumper C et al (2009) Long-term follow-up after ovarian borderline tumor: relapse and survival in a large patient cohort. Eur J OBstet Gynecol Reprod Biol 145:189\u0026ndash;194\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRenn J, Peng Z, Yang K (2008) A clinicopathologic multivariate analysis affecting recurrence of borderline ovarian tumors. Gyneco Oncol 110:162\u0026ndash;167\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSeong SJ, Kim DH, Kim MK, Song T (2015) Controversies in borderline ovarian tumors. J Gynecol Oncol 26:343\u0026ndash;349\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShih KK, Zhou Q, Huh J et al (2011) Risk factors for recurrence of ovarian borderline tumors. Gynecol Oncol 120:480\u0026ndash;484\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRasmussen ELK, Hannibal CG, Dehlendorff C, Baandrup L, Junge J, Vang R, Kurman RJ, Kjaer SK (2017) Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study. Gynecol Oncol 144:571\u0026ndash;576\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLongacre TA, McKenney JK, Tazelaar HD, Kempson RL, Hendrickson MR (2005) Ovarian serous tumors of low malignant potential (borderline tumors): outcome-based study of 276 patients with long-term (\u0026gt; or = 5-year) follow-up. Am J Surg Pathol 29:707\u0026ndash;723\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFang C, Zhao L, Chen X, Yu A, Xia L, Zhang P (2018) The impact of clinicopathologic and surgical factors on relapse and pregnancy in young patients (\u0026le; 40 years old) with borderline ovarian tumors. BMC Cancer 18:1147\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUzan C, Nikpayam M, Ribassin-Majed L, Gouy S, Bendifallah S, Cortez A, Rey A, Duvillard P, Darai E, Morice P (2014) Influence of histological subtypes on the risk of an invasive recurrence in a large series of stage I borderline ovarian tumor including 191 conservative treatments. Ann Oncol 25:1312\u0026ndash;1319\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLoizzi V, Selvaggi L, Leone L, Latorre D, Scardigno D, Magazzino F, Cormio G (2015) Borderline epithelial tumors of the ovary: Experience of 55 patients. Oncol Lett 9:912\u0026ndash;914\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSilva EG, Gershenson DM, Malpica A, Deavers M (2006) The recurrence and the overall survival rates of ovarian serous borderline neoplasms with noninvasive implants is time dependent. Am J Surg Pathol 30:1367\u0026ndash;1371\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSong T, Kim MK, Jung YW, Yun BS, Seong SJ, Choi CH, Kim TJ, Lee JW, Bae DS, Kim BG (2017) Minimally invasive compared with open surgery in patients with borderline ovarian tumors. Gynecol Oncol 145:508\u0026ndash;512\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSherman ME, Berman J, Birrer MJ, Cho KR, Ellenson LH, Gorstein F, Seidman JD (2004) Current challenges and opportunities for research on borderline ovarian tumors. Hum Pathol 35:961\u0026ndash;970\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSherman ME, Mink PJ, Curtis R, Cote TR, Brooks S, Hartge P, Devesa S (2004) Survival among women with borderline ovarian tumors and ovarian carcinoma: a population-based analysis. Cancer 100:1045\u0026ndash;1052\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTrimble CL, Kosary C, Trimble EL (2002) Long-term survival and patterns of care in women with ovarian tumors of low malignant potential. Gynecol Oncol 86:34\u0026ndash;37\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003edu Bois A, Trillsch F, Mahner S, Heitz F, Harter P (2016) Management of borderline ovarian tumors. Ann Oncol 27:i20\u0026ndash;i22\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQi Y, Wang M, Yang Y, Zeng Z, Zhou Y (2021) Analysis of Factors Influencing Relapse and Pregnancy in Patients with Borderline Ovarian Tumors. J Cancer 12:5275\u0026ndash;5285\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUzan C, Muller E, Kane A, Rey A, Gouy S, Bendiffallah S, Duvillard P, Fauvet R, Darai E, Morice P (2014) Prognostic factors for recurrence after conservative treatment in a series of 119 patients with stage I serous borderline tumors of the ovary. Ann Oncol 25:166\u0026ndash;171\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen RF, Li J, Zhu TT, Yu HL, Lu X (2016) Fertility-sparing surgery for young patients with borderline ovarian tumors (BOTs): single institution experience. J Ovarian Res 9:16\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWarne GL, Fairley KF, Hobbs JB et al (1973) Cyclophosphamide induced ovarian failure. N Engl J Med 289:1159\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"borderline ovarian tumor, recurrence, pregnancy, fertility sparing surgery,","lastPublishedDoi":"10.21203/rs.3.rs-1448580/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1448580/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003eThis study analyzed the risk factors affecting recurrence in patients with borderline ovarian tumors （BOTs）after radical surgery and the risk factors influencing recurrence and pregnancy in patients after fertility sparing surgery (FSS).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis is a\u003cstrong\u003e \u003c/strong\u003eretrospective cohort study. Data was collected from clinical data of patients in the Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2005 to November 2021. The clinicopathological and surgical variables were analyzed by univariate analyses and survival curves.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA total of 169 BOT patients were included in this study. The median age was 45 years. Median follow-up time was 81months. Among these patients, 21 patients relapsed. There were 60 patients receiving FSS, of the 16 patients attempting to conceive, 13 patients have successfully conceived spontaneously. In univariate analyses, FIGO stage, invasive implantation, and chemotherapy were risk factors for recurrence of BOTs. FIGO stage was the only one risk factor after multivariate analysis. Tumor size and tumor site were risk factors for recurrence of BOTs receiving FSS. We didn’t find any risk factor for pregnancy of BOTs receiving FSS.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eAfter univariate analysis and multivariate analysis, we found some risk factors for recurrence after radical surgery or FSS, but they didn’t affect the overall survival rate and pregnancy rate. Laparoscopy procedure is recommended and chemotherapy is not recommended for patients receiving FSS. We suggest that patients who preserve fertility should get pregnant as soon as possible and follow up closely.\u003c/p\u003e","manuscriptTitle":"Risk factors of recurrence and pregnancy in patients with borderline ovarian tumors: a retrospective study with 16-year follow-up","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2022-09-27 15:12:19","doi":"10.21203/rs.3.rs-1448580/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2022-03-29 16:10:25","doi":"10.21203/rs.3.rs-1448580/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4f1678f4-d6d9-459c-8289-55d022bdc0e8","owner":[],"postedDate":"September 27th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2022-12-13T20:20:29+00:00","versionOfRecord":[],"versionCreatedAt":"2022-09-27 15:12:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-1448580","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1448580","identity":"rs-1448580","version":["v2"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}