Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: a randomized controlled study.
BACKGROUND
During the childbearing years, the standard fertility-sparing treatment for bilateral borderline ovarian tumours (BOTs) is the unilateral oophorectomy plus controlateral cystectomy. The aim of the present study was to compare the effects of two laparoscopic fertility-sparing surgical procedures for the treatment of bilateral BOTs on recurrence and fertility in young women who desire to conceive as soon as possible.


METHODS
Thirty-two women affected by bilateral early-stage BOTs who desired to conceive were randomized to receive bilateral cystectomy (experimental group, n=15) or oophorectomy plus controlateral cystectomy (control group, n=17). At the first recurrence after childbearing completion, each patient was treated with non-conservative standard treatment. Recurrences and reproductive events were recorded.


RESULTS
After a follow-up period of 81 months (19 inter-quartile; 60-96 range), the cumulative pregnancy rate (CPR) (14/15 versus 9/17; P=0.003) and the cumulative probability of first pregnancy (P= 0.011) were significantly higher in the experimental than in control group. No significant (P=0.358) difference between groups was detected in cumulative probability of first recurrence.


CONCLUSIONS
The laparoscopic bilateral cystectomy followed by non-conservative treatment performed at the first recurrence after the childbearing completion is an effective surgical strategy for patients with bilateral early-stage BOTs who desire to conceive as soon as possible.
Palomba
S
S
Department of Obstetrics and Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
Zupi
E
E
Russo
T
T
Falbo
A
A
Del Negro
S
S
Manguso
F
F
Marconi
D
D
Tolino
A
A
Zullo
F
F
D000328:Adult; D015653:Cystectomy; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control*; D010535:Laparoscopy; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy; D011247:Pregnancy; D018873:Pregnancy Rate