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Annals of Oncology Advance Access published online on July 16, 2009
Annals of Oncology, doi:10.1093/annonc/mdp267
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Outcomes after conservative treatment of advanced-stage serous borderline tumors of the ovary

C. Uzan1, A. Kane1, A. Rey2, S. Gouy1, P. Duvillard3 and P. Morice1,4,*

1 Department of Gynecologic Surgery
2 Department of Biostatistics
3 Department of Pathology
4 University Paris Sud, Institut Gustave Roussy, Villejuif, France

* Correspondence to: Dr P. Morice, Department of Gynecologic Surgery, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France. Tel: +33-1-42-11-44-39; Fax: +33-1-42-11-52-13; E-mail: morice{at}igr.fr

Background: The aim of this study was to assess the outcomes of the largest series of patients treated conservatively for a stage II or III serous borderline ovarian tumor.

Materials and methods: From 1969 to 2006, 41 patients were treated conservatively for an advanced-stage serous borderline ovarian tumor. Patient outcomes were reviewed.

Results: Twenty patients had undergone a unilateral salpingo-oophorectomy, 18 a unilateral cystectomy and two bilateral cystectomy (unknown for one patient). Three patients had invasive implants. The median duration of follow-up was 57 months (range 4–235). The recurrence rate was high (56%), but overall survival remained excellent (100% at 5 years, 92% at 10 years). One death had occurred due to an invasive ovarian recurrence. Eighteen pregnancies (nine spontaneous) were observed in 14 patients.

Conclusions: This study demonstrates that spontaneous pregnancies can be achieved after conservative treatment of advanced-stage borderline ovarian tumors (with noninvasive implants) but the recurrence rate is high. Nevertheless, this high rate has no impact on survival. Conservative surgery can be proposed to patients with a borderline tumor of the ovary and noninvasive peritoneal implants. Should infertility persist following treatment of the borderline tumor, an in vitro fertilization procedure can be cautiously proposed.

borderline tumor, fertility, invasive implants, IVF, ovary, pregnancy, recurrence

Received for publication January 27, 2009. Revision received March 19, 2009. Accepted for publication April 6, 2009.


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