Fertility-sparing surgery in children and adolescents with borderline ovarian tumors: A retrospective study

Abstract Objective To describe the characteristics of children and adolescents with borderline ovarian tumors (BOTs) and evaluate the efficacy and safety of fertility-sparing surgery (FSS) in these patients. Methods Patients with BOTs aged 21 years or younger who underwent FSS were included in this study. Results A total of 38 patients were included, with a median patient age of 17 (range, 3–21) years; 97.4% (37/38) of cases occurred after menarche. Of the patients, 78.9% had mucinous borderline tumors (MBOTs), 18.4% had serous borderline tumors (SBOTs), and 2.6% had seromucinous borderline tumor. The median tumor size was 20 cm (range, 8–40 cm). The median preoperative carcinoma antigen 125 level was 47.5 U/mL. All patients were at International Federation of Gynecology and Obstetrics stage I and all underwent FSS: cystectomy (18/38; 47.4%), unilateral salpingo-oophorectomy (USO; 19/38; 50%), or USO + contralateral ovarian cystectomy (1/38; 2.6%). The median follow-up time was 57 (10–148) months. Recurrence was experienced by 13 of the 38 patients (34.2%). One patient with SBOT experienced progression to low-grade serous carcinoma after the third relapse. Two patients went on to have a total of four pregnancies, resulting in two live births. The 5-year disease-free survival rate was 65.8%, and the 5-year overall survival rate was 100%. Conclusions FSS is feasible and safe for children and adolescents with BOTs. For patients with MBOTs, USO is recommended to lower the risk of recurrence.