Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: A randomized controlled study

S. Palomba, E. Zupi, T. Russo, A. Falbo, S. Del Negro, F. Manguso, D. Marconi, A. Tolino, F. Zullo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: During the childbearing years, the standard fertility-sparing treatment for bilateral borderline ovarian tumours (BOTs) is the unilateral oophorectomy plus controlateral cystectomy. The aim of the present study was to compare the effects of two laparoscopic fertility-sparing surgical procedures for the treatment of bilateral BOTs on recurrence and fertility in young women who desire to conceive as soon as possible. Methods: Thirty-two women affected by bilateral early-stage BOTs who desired to conceive were randomized to receive bilateral cystectomy (experimental group, n = 15) or oophorectomy plus controlateral cystectomy (control group, n = 17). At the first recurrence after childbearing completion, each patient was treated with non-conservative standard treatment. Recurrences and reproductive events were recorded. Results: After a follow-up period of 81 months (19 inter-quartile; 60-96 range), the cumulative pregnancy rate (CPR) (14/15 versus 9/17; P = 0.003) and the cumulative probability of first pregnancy (P = 0.011) were significantly higher in the experimental than in control group. No significant (P = 0.358) difference between groups was detected in cumulative probability of first recurrence. Conclusions: The laparoscopic bilateral cystectomy followed by non-conservative treatment performed at the first recurrence after the childbearing completion is an effective surgical strategy for patients with bilateral early-stage BOTs who desire to conceive as soon as possible.

Original languageEnglish
Pages (from-to)578-585
Number of pages8
JournalHuman Reproduction
Volume22
Issue number2
DOIs
Publication statusPublished - Feb 2007

Keywords

  • Borderline ovarian tumour
  • Cystectomy
  • Fertility
  • Recurrence
  • Surgery

ASJC Scopus subject areas

  • Physiology
  • Developmental Biology
  • Obstetrics and Gynaecology
  • Reproductive Medicine

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