Clinical outcomes and fertility after conservative treatment of ovarian borderline tumors.
OBJECTIVE
To assess clinical outcome and fertility in patients treated conservatively for a low malignant potential (LMP) ovarian tumor.


METHODS
Retrospective study.


METHODS
Gynecologic oncology department of a cancer care center in France.


METHODS
Forty-four patients treated with conservative management for a stage I (n = 32) or stage II or III (n = 12) LMP tumor.


METHODS
Thirty-three patients had unilateral adnexectomy and 11 had cystectomy. Cystectomy was bilateral in 1 patient and was done in conjunction with contralateral adnexectomy in 5 patients.


METHODS
Tumor recurrence and pregnancy rates.


RESULTS
Tumor recurrence rates after radical surgery (hysterectomy with bilateral salpingo-oophorectomy), adnexectomy, and cystectomy were 5.7%, 15.1%, and 36.3%, respectively (P<.01). Among patients who initially received conservative treatment, tumors did not recur in the form of invasive carcinoma. Five patients who had recurrence underwent repeated conservative management; these patients are alive and free of disease. Seventeen pregnancies (of which 15 were spontaneous) occurred in 14 patients; 13 pregnancies occurred in patients with stage I disease and 4 occurred in patients with stage III disease.


CONCLUSIONS
Conservative management of LMP tumor significantly increases the risk of recurrence but does not affect overall survival. Such management offers even patients with advanced disease the chance to have spontaneous pregnancy. Conservative management might be proposed in young patients who wish to preserve their fertility, but careful follow-up will be required to detect tumor recurrence.
Morice
P
P
Service de Chirurgie Gynécologique,Institut Gustave Roussy, Villejuif, France.
Camatte
S
S
El Hassan
J
J
Pautier
P
P
Duvillard
P
P
Castaigne
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005298:Fertility / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012008:Recurrence; D013534:Survival; D016896:Treatment Outcome