title: Borderline ovarian tumors: clinical characteristics, management, and outcomes - a multicenter study.
abstract: BACKGROUND
  The optimal surgical management and staging of borderline ovarian tumors (BOTs) are controversial. Institutions have different surgical approaches for the treatment of BOTs. Here, we performed a retrospective review of clinical characteristics, surgical management and surgical outcomes, and sought to identify variables affecting disease-free survival (DFS) and overall survival (OS) in patients with BOTs.
  
  
  METHODS
  A retrospective review of ten gynecological oncology department databases in Turkey was conducted to identify patients diagnosed with BOTs. The effects of type of surgery, age, stage, surgical staging, complete versus incomplete staging, and adjuvant chemotherapy were examined on DFS and OS.
  
  
  RESULTS
  In total, 733 patients with BOTs were included in the analysis. Most of the staged cases were in stage IA (70.4 %). In total, 345 patients underwent conservative surgeries. Recurrence rates were similar between the conservative and radical surgery groups (10.5 % vs. 8.7 %). Furthermore we did not find any difference between DFS (HR = 0.96; 95 % confidence interval, CI = 0.7-1.2; p = 0.576) or OS (HR = 0.9; 95 % CI = 0.8-1.1; p = 0.328) between patients who underwent conservative versus radical surgeries. There was also no difference in DFS (HR = 0.74; 95 % CI = 0.8-1.1; p = 0.080) or OS (HR = 0.8; 95 % CI = 0.7-1.0; p = 0.091) between complete, incomplete, and unstaged patients. Furthermore, receiving adjuvant chemotherapy (CT) for tumor stage ≥ IC was not an independent prognostic factor for DFS or OS.
  
  
  CONCLUSIONS
  Patients undergoing conservative surgery did not show higher recurrence rates; furthermore, survival time was not shortened. Detailed surgical staging, including lymph node sampling or dissection, appendectomy, and hysterectomy, were not beneficial in the surgical management oF BOTs.
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gokcu
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Mugla Sıtkı Kocman University Education and Research Hospital, Mentese, 48000, Mugla, Turkey. maidenkemal@yahoo.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Gungorduk
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Aşıcıoğlu
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zekai Tahir Burak Education and Research Hospital, Ankara, Turkey.
authors.forename: Nilüfer
authors.initials: N
authors.lastname: Çetinkaya
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zekai Tahir Burak Education and Research Hospital, Ankara, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Güngör
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zeynep Kamil Education and Research Hospital, Istanbul, Turkey.
authors.forename: Gonca
authors.initials: G
authors.lastname: Pakay
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zekai Tahir Burak Education and Research Hospital, Ankara, Turkey.
authors.forename: Zeliha Fırat
authors.initials: ZF
authors.lastname: Cüylan
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Toptaş
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Istanbul Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Özyurt
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Ağaçayak
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Ozdemir
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Erol
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zonguldak Bulent Ecevit University School of Medicine, Zonguldak, Turkey.
authors.forename: Anıl
authors.initials: A
authors.lastname: Turan
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Varol
authors.initials: V
authors.lastname: Gülseren
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Mehmet Sait
authors.initials: MS
authors.lastname: İcen
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zeynep Kamil Education and Research Hospital, Istanbul, Turkey.
authors.forename: Taylan
authors.initials: T
authors.lastname: Şenol
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Güraslan
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Dicle University School of Medicine, Diyarbakır, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Yücesoy
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zonguldak Bulent Ecevit University School of Medicine, Zonguldak, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sahbaz
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Ozgu
authors.initials: O
authors.lastname: Gungorduk
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
authors.forename: Berhan
authors.initials: B
authors.lastname: Besimoğlu
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zeynep Kamil Education and Research Hospital, Istanbul, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Pakay
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Temizkan
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Sancı
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Tayup
authors.initials: T
authors.lastname: Şimşek
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zekai Tahir Burak Education and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet Mutlu
authors.initials: MM
authors.lastname: Meydanlı
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zonguldak Bulent Ecevit University School of Medicine, Zonguldak, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Harma
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Yaşar
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Istanbul Education and Research Hospital, Istanbul, Turkey.
authors.forename: Birtan
authors.initials: B
authors.lastname: Boran
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Aysel Derbent
authors.initials: AD
authors.lastname: Uysal
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Zeynep Kamil Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ateş
authors.initials: A
authors.lastname: Karateke
mesh_terms: D000328:Adult; D001706:Biopsy; D003131:Combined Modality Therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
keywords: Adjuvant chemotherapy; Borderline ovarian tumor; Surgery