Ultra-conservative fertility-sparing strategy for bilateral borderline ovarian tumours: An 11-year follow-up

Stefano Palomba, Angela Falbo, Serena Del Negro, Morena Rocca, Tiziana Russo, Francesco Cariati, Gianluca Annunziata, Achille Tolino, Pierosandro Tagliaferri, Fulvio Zullo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: This is a prospective long-term extension study of a randomized controlled trial aimed to assess the risk-benefit ratio of an ultra-conservative fertility-sparing approach in patients with bilateral borderline ovarian tumours (BOTs). Methods: The experimental group (n = 15) was treated with an ultra-conservative surgical approach consisting of bilateral cystectomy, whereas the control group (n = 17) received a less conservative surgery consisting of oophorectomy plus controlateral cystectomy alone. All patients received a complete laparoscopic staging followed by a fertility enhancement programme. Patients who completed childbearing were treated with a non-conservative standard treatment at the first recurrence. Results: After a follow-up period of 128 (9 interquartile range (IQR); 115-150 range) and 132 (7 IQR; 117-152 range) months for the experimental and control groups, respectively (P = 0.25), the time to first baby-in-arm (P <0.02) and the relative rate (RR) of baby-in-arm (8.05 [95 confidence interval (CI), 1.20-9.66; P <0.01]) were significantly lower and higher, respectively, for the experimental compared with the control group. Although the time to first recurrence was significently (P <0.01) shorter for the experimental group, in the regression analysis the difference did not reach the statistic significance (P = 0.14), and the RR of recurrence (1.23 [95 CI, 0.62-3.17; P = 0.41]) was not significant. Finally the number needed to treat for pregnancy was three, the number needed to harm for radical surgery was only two. Conclusions: The ultra-conservative fertility-sparing approach is more effective than the standard approach in terms of reproductive outcomes, but presents a higher oncological risk.

Original languageEnglish
Pages (from-to)1966-1972
Number of pages7
JournalHuman Reproduction
Volume25
Issue number8
DOIs
Publication statusPublished - Aug 2010

Keywords

  • BOTs
  • fertility-sparing strategy
  • pregnancy
  • recurrence
  • ultra-conservative surgery

ASJC Scopus subject areas

  • Rehabilitation
  • Obstetrics and Gynaecology
  • Reproductive Medicine

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