Long-term follow-up after ovarian borderline tumor: relapse and survival in a large patient cohort

Abstract

Objectives: To assess long-term survival and relapse rate of patients diagnosed with a borderline tumor of the ovary (BOT) with special focus on the influence of primary surgery.

Study design: All women diagnosed and treated for BOT between 1983 and 2006 at our institution were included in this retrospective study. Clinical data including operative procedure, stage and histology at first diagnosis as well as follow-up data were analyzed with reference to survival times and relapse rates.

Results: Altogether 113 patients could be identified, including 19 women treated with fertility sparing surgery (19.2%). Mean follow-up time was 9.6+/-6.6 years. Relapse occurred during the follow-up period in 10 patients (10.1%) with a mean time to recurrence of 2.0+/-1.7 years. Patients with recurrent disease had a statistically significantly worse survival: 5- and 10-year survival rates were 90.0 and 80.0% compared with 98.9 and 94.4% for those without (p=0.0208), respectively. Relapse rate was 7.1% in early borderline patients (Ia: 4/56) and 14% (>Ia: 6/43) for all others (p=0.436). Patients with invasive implants had a statistically significantly higher relapse rate (p=0.0112). No significant difference in relapse rates or survival was observed between the histological subtypes. Five- and 10-year survival rates of women treated with fertility sparing surgery (n=19) were 100% and thus not worse than those of radically operated patients (5- and 10-year survival 95.1 and 90.1%). Relapse rates in both groups were comparable with 10.5 and 10.0% (p=0.723). The surgical procedure with lymphadenectomy vs. without had no influence on relapse or survival, neither did laparoscopy vs. laparotomy.

Conclusion: Our findings confirm the good prognosis of BOT in general. Patients with invasive implants have higher relapse rates. Fertility sparing surgery in women at childbearing age can be an adequate treatment option in early stage disease.