Fertility saving surgery for borderline ovarian tumours

Recurrence and Malignant Transformation After Borderline Ovarian Tumours: A Systematic Review and Meta-analysis

https://tinyurl.com/yk7et5rw

Borderline ovarian tumours make up 10 to 20% of ovarian masses. They present at an earlier age and rarely progress to invasive cancer. Because of this, surgery for these tumours is often limited to removal of the ovarian mass with preservation of fertility.

This analysis of all the available information looks at the risks of recurrence and malignant change to determine whether limited fertility-saving surgery is harmful.

More than 5000 women were included who underwent surgery for borderline tumours, which included complete clearance for some, with others having less radical surgery, many for preservation of fertility. Recurrence of the tumour is more likely with limited surgical clearance, with as much as a 30% chance in some instances. Those women who had radical surgery had a low risk of recurrence at about 3%.

Progression to invasive cancer is rare, in about 1% of the whole group. The risk increases after recurrence, with up to 20% malignant change after local recurrence. Usually, the cancer is of low grade, with survival rates at around 60%.

The authors suggest that fertility-saving surgery has serious consequences and that informed consent should include the increased risk of recurrence and malignancy.