title: Safety of ovarian conservation and fertility preservation in advanced borderline ovarian tumors.
abstract: OBJECTIVE
  To assess the impact of a fertility-sparing approach on disease recurrence in women with advanced borderline ovarian tumors.
  
  
  METHODS
  Historic cohort study.
  
  
  METHODS
  A tertiary referral center for gynecological oncology patients and a university teaching hospital.
  
  
  METHODS
  Consecutive patients with advanced borderline ovarian tumors defined as stage IC and above, treated at a single institution during a span of 30 years.
  
  
  METHODS
  Data on surgical approach (e.g., fertility sparing, ovarian conserving) as well as histopathology, disease stage, CA-125 level, and use of chemotherapy were collected from the medical records, and their impact on disease recurrence was assessed.
  
  
  METHODS
  Recurrence-free interval. Its association with the type of surgery and with other clinical and pathological features was assessed using the Kaplan Meier and Cox proportional hazards methods.
  
  
  RESULTS
  Fifty-nine patients with advanced disease were identified. Median follow-up was 55.3 months. Mean age at diagnosis was 35 years. Most of the tumors (51, 84.4%) had serous histology. Twenty-seven patients (45.8%) developed recurrences and 6 (10%) died of their disease. Mean time to recurrence was 30.6 months. Of 44 women ≤40 years, 33 (75%) had a fertility-sparing procedure. Fertility preservation was not associated with disease recurrence. A total of 34 pregnancies and 26 live births were documented among 21 patients attempting conception.
  
  
  CONCLUSIONS
  Borderline ovarian tumors carry a favorable prognosis, even at an advanced stage. Fertility preservation was not found to be associated with an increased risk of relapse in young patients with advanced disease, and may be reasonably considered.
authors.affiliation: Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: lhelpman@gmail.com.
authors.forename: Limor
authors.initials: L
authors.lastname: Helpman
authors.affiliation: Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Mario E
authors.initials: ME
authors.lastname: Beiner
authors.affiliation: Institute of Pathology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Sarit
authors.initials: S
authors.lastname: Aviel-Ronen
authors.affiliation: Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Perri
authors.affiliation: Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Hogen
authors.affiliation: Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Ariella
authors.initials: A
authors.lastname: Jakobson-Setton
authors.affiliation: Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gilad
authors.initials: G
authors.lastname: Ben-Baruch
authors.affiliation: Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Korach
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects / Q000639:trends*; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000628:therapy; D010053:Ovary; D011247:Pregnancy; D012189:Retrospective Studies
keywords: Borderline ovarian tumor; fertility preservation; ovarian conservation