Recurrence after cystectomy for borderline ovarian tumors: results of a French multicenter study.
BACKGROUND
Fertility-sparing surgery for borderline ovarian tumors (BOT) is feasible and effective and does not seem to have a negative effect on survival. Specific data on the effect of cystectomy, and notably on recurrence, are lacking.


METHODS
This was a French retrospective multicenter study of 313 women with stage I BOT treated from 1990 to 2000 in 13 specialized gynecological units and 1 cancer center. Diagnosis and staging were based on International Federation of Gynecology and Obstetrics (1989) criteria. Surgery consisted of cystectomy, unilateral salpingo-oophorectomy (USO), or bilateral salpingo-oophorectomy (BSO).


RESULTS
After cystectomy, persistent BOT and benign ovarian cysts on the operated ovary were observed in 15% and 65% of patients, respectively. Mean follow-up did not differ among patients receiving the three types of surgery. The recurrences after cystectomy, USO, and BSO treatment were 30.3%, 11%, and 1.7%, respectively (P<.0001). Recurrences were more frequent after cystectomy than after USO (P=.0001) and BSO (P=.0001) and when intraoperative cyst rupture occurred (P=.04).


CONCLUSIONS
These results suggest that cystectomy for BOT is associated with a high risk of intraoperative cyst rupture and of recurrence compared with USO or BSO.
Service de Gynécologie-Obstétrique, Hôpital Tenon, AP-HP, 4 Rue de la Chine, CancerEst, UFR Saint-Antoine, Paris VI, 75020, France.
Christophe
C
Poncelet
Raffaèle
R
Fauvet
Joëlle
J
Boccara
Emile
E
Daraï
D000328:Adult; D015653:Cystectomy; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010048:Ovarian Cysts; D010051:Ovarian Neoplasms / Q000401:mortality / Q000601:surgery*; D010052:Ovariectomy; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000601:surgery*