title: Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: a randomized controlled study.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
authors.forename: S
authors.initials: S
authors.lastname: Palomba
authors.forename: E
authors.initials: E
authors.lastname: Zupi
authors.forename: T
authors.initials: T
authors.lastname: Russo
authors.forename: A
authors.initials: A
authors.lastname: Falbo
authors.forename: S
authors.initials: S
authors.lastname: Del Negro
authors.forename: F
authors.initials: F
authors.lastname: Manguso
authors.forename: D
authors.initials: D
authors.lastname: Marconi
authors.forename: A
authors.initials: A
authors.lastname: Tolino
authors.forename: F
authors.initials: F
authors.lastname: Zullo
mesh_terms: 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