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Recurrence After Cystectomy for Borderline Ovarian Tumors: Results of a French Multicenter Study

¹ Service de Gynécologie-Obstétrique, Hôpital Tenon, AP-HP, 4 Rue de la Chine, CancerEst, UFR Saint-Antoine, 75020 Paris VI, France
² UFR SMBH Léonard De Vinci, Université Paris XIII, 93017 Bobigny Cedex, Paris, France

Correspondence: Address correspondence and reprint requests to: Emile Daraï, MD, PhD; E-mail: emile.darai{at}tnn.ap-hop-paris.fr.

Background: Fertility-sparing surgery for borderline ovarian tumors (BOT) is feasible and effective and does not seem to have a negative effect on survival. Specific data on the effect of cystectomy, and notably on recurrence, are lacking.

Methods: This was a French retrospective multicenter study of 313 women with stage I BOT treated from 1990 to 2000 in 13 specialized gynecological units and 1 cancer center. Diagnosis and staging were based on International Federation of Gynecology and Obstetrics (1989) criteria. Surgery consisted of cystectomy, unilateral salpingo-oophorectomy (USO), or bilateral salpingo-oophorectomy (BSO).

Results: After cystectomy, persistent BOT and benign ovarian cysts on the operated ovary were observed in 15% and 65% of patients, respectively. Mean follow-up did not differ among patients receiving the three types of surgery. The recurrences after cystectomy, USO, and BSO treatment were 30.3%, 11%, and 1.7%, respectively (P < .0001). Recurrences were more frequent after cystectomy than after USO (P = .0001) and BSO (P = .0001) and when intraoperative cyst rupture occurred (P = .04).

Conclusions: These results suggest that cystectomy for BOT is associated with a high risk of intraoperative cyst rupture and of recurrence compared with USO or BSO.

Key Words: Borderline ovarian tumors • Recurrence • Cystectomy • Persistent tumor • Salpingo-oophorectomy

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