title: Identification of factors that impact recurrence in patients with borderline ovarian tumors.
abstract: BACKGROUND
  The lack of consensus around best practices for management of borderline ovarian tumors (BOT) is, in part, to the lack of available data and of clarity in interpreting relationships among various factors that impact outcomes. The objective of this study was to identify clinicopathological factors that impact prognosis of patients with borderline ovarian tumors (BOT) and to address features of this disease with the objective of providing clarity in decision making around management of BOT.
  
  
  RESULTS
  A total of 178 BOT patients were included in this study, with a median age of 43 years and a median follow-up time of 37 months. Thirty-two (18.0%) recurrences and 5 (2.8%) deaths were observed in this study group. Multivariate analysis showed that fertility-preserving surgery (P = 0.0223 for bilateral cystectomy) and invasive implants (P = 0.0030) were significantly associated with worse PFS, whereas lymphadenectomy (P = 0.0129) was related to improved PFS. No factors were found to be associated with OS due to the limited number of deaths. In addition, patients with serous BOT more commonly had abnormal levels of CA125, while patients with mucinous BOT more commonly had abnormal levels of CEA. Patients with abnormal levels of CA125, or CA19-9, or HE4 had significantly larger tumor sizes.
  
  
  CONCLUSIONS
  Our study reveals the impact of certain types of fertility-preserving surgery, lymphadenectomy and invasive implants on PFS of BOT patients. Blood cancer markers may be associated with histology and size of BOT. Our findings may assist in selection of optimum treatment for BOT patients.
authors.affiliation: Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China.
authors.forename: Chenyan
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhu
authors.affiliation: Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China. yuaj@zjcc.org.cn.
authors.forename: Aijun
authors.initials: A
authors.lastname: Yu
authors.affiliation: Department of Cancer Biology, Wake Forest School of Medicine, Winston Salem, NC, 27157, USA.
authors.forename: Shihua
authors.initials: S
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis; D055815:Young Adult
keywords: Borderline ovarian tumor; Fertility-preserving surgery; Lymphadenectomy; Recurrence; Survival