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KMID : 1137020220330000005
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Journal of Gynecologic Oncology
2022 Volume.33 No. 0 p.5 ~ p.5
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Oncological and reproductive outcomes after fertility-sparing surgery in patients with seromucinous borderline ovarian tumor: results of a large retrospective study
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Wang Dan
Jia Shuangzheng
Jia Congwei
Cao Dongyan
Yang Jiaxin
Yang Junjun
Xiang Yang
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Abstract
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Objective: To evaluate the oncological and reproductive outcomes in patients with seromucinous borderline ovarian tumors (SMBOT) treated with fertility-sparing surgery (FSS).
Methods: We retrospectively reviewed the medical records of patients with SMBOT who underwent surgery between 2000 and 2019. A centralized histological review was performed and recurrence rates were compared between different surgical procedures.
Results: A total of 105 patients fulfilled the inclusion criteria, of whom 65 underwent FSS and 40 were treated with radical surgery. Fourteen patients had recurrent disease after a median follow-up time of 59.6 months (range: 22.1?256.8 months). All but one relapsed with SMBOT. There was no significant difference in disease-free survival (DFS) between the 2 groups (p=0.141). Multivariate analysis showed that only bilateral involvement was associated with increased recurrence (p=0.008). In the subgroup of patients treated with conservative surgery, there was no significant difference in DFS with regard to surgical procedures (ovarian cystectomy vs. salpingo-oophorectomy, p=0.487). Of the 12 patients in the FSS group who developed recurrence, 11 underwent a second round of FSS and all remained alive with no evidence of disease at the end of follow-up. Of 20 patients desiring pregnancy, 16 patients were successful and resulted in 17 term deliveries.
Conclusion: FSS is feasible for young patients who wish to preserve their fertility. Patients initially treated with ovarian cystectomy may be managed by close surveillance if post-operative imaging are negative. Repeat FSS remains a valuable alternative for young patients with recurrent SMBOT after thorough communication.
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