Abstract
BackgroundThis study was to determine age-specific impact of fertility preserving surgery on disease-specific survival in women with stage I borderline ovarian tumors (BOTs). Patients diagnosed during 1988–2000 were selected from The Surveillance, Epidemiology, and End Results (SEER) database. The age-specific impact of fertility preserving surgery and other risk factors were analyzed in patients with stage I BOTs using Cox proportion hazard regression models. Data from our hospital were collected during 1996–2017 to determine the prevalence of patients who had undergone fertility preserving surgery.ResultsOf a total 6295 patients in the SEER database, this study selected 2946 patients with stage T1 BOTs who underwent fertility preserving or radical surgery. Their median age at diagnosis was 45.0 years and the median follow-up time was 200 months. Fertility preserving surgery was performed in 1000/1751 (57.1%) patients < 50 years and in 1,81/1195 (15.1%) patients ≥50 years. Fertility preserving surgery was significantly associated with worse disease-specific survival only in patients ≥50 years. Increased age, stage T1c and mucinous histology were risk factors for overall patients or patients ≥50 years, but not for < 50 years. Data from our hospital showed that fertility preserving surgery was performed in 53.9 and 12.3%patients < 50 and ≥ 50 years with stage I disease, respectively.ConclusionFertility preserving surgery is safe for women < 50 years with early staged BOTs, but it may decrease disease-specific survival in patients ≥50 years. Conservative surgery is performed at a relatively high rate in patients ≥50 years.
Highlights
This study was to determine age-specific impact of fertility preserving surgery on disease-specific survival in women with stage I borderline ovarian tumors (BOTs)
Based on our inclusion and exclusion criteria, a total of 2946 cases with stage I BOTs were included in this study
Multivariate analysis showed that the increased age (HR = 1.04, 95% CI: 1.01–1.07, P = 0.0108), fertility preserving surgery (HR = 1.99, 95% CI: 1.059–3.77, P = 0.0253), stage T1c (HR = 2.87, 95% CI: 1.41–5.86, P = 0.0037) and mucinous histology (HR = 1.87, 95% CI: 1.07–3.27, P = 0.0278) were risk factors significantly associated with worse disease-specific survival (Table 5)
Summary
This study was to determine age-specific impact of fertility preserving surgery on disease-specific survival in women with stage I borderline ovarian tumors (BOTs). Serous and mucinous BOTs are the two major histological types [2] These tumors have a low malignant potential to spread beyond the ovary with peritoneal involvement [1] and have an excellent prognosis [3,4,5]. This disease accounts for 10–15% of all epithelial ovarian cancers [6]. Fertility preserving surgery was not shown to compromise overall survival in these patients [16,17,18,19]
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