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Original Research

Open Access

Exploring the impact of surgical interventions and identifying risk factors for recurrence in stage I of borderline ovarian tumors

  • Seon-Mi Lee1
  • Sanghoon Lee1,*,
  • Jae-Yun Song1
  • Aeran Seol1
  • Hyun-Woong Cho2
  • Kyung-Jin Min3
  • Jin-Hwa Hong2
  • Jae-Kwan Lee2
  • Nak-Woo Lee3

1Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, 02841 Seoul, Republic of Korea

2Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Guro Hospital, 08308 Seoul, Republic of Korea

3Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Ansan Hospital, 15355 Ansan, Republic of Korea

DOI: 10.22514/ejgo.2024.030 Vol.45,Issue 2,April 2024 pp.75-87

Submitted: 25 July 2023 Accepted: 25 August 2023

Published: 15 April 2024

*Corresponding Author(s): Sanghoon Lee E-mail: mdleesh@korea.ac.kr

Abstract

This research aimed to evaluate surgical intervention’s influence on borderline ovarian tumors (BOTs) outcomes and identify contributing recurrence risk factors. BOT patients at Korea University Anam Hospital (2006–2023) were classified based on recurrence. Surgical interventions were classified conservative, comprehensive or staging surgeries. Each group’s characteristics, surgical interventions, disease-free survival (DFS), overall survival (OS), and recurrence risk factors were compared and analyzed. Statistical analyses included student’s t-test, chi-square test, Fisher’s exact test, Kaplan-Meier analysis, and Cox regression analyzing using SPSS. Of 177 patients, 170 were in the no recurrence group, and seven were in the recurrence group. Four relapsed patients had a borderline recurrence, and three had a malignant transformation. The median follow-up period for all participants was 47 months. There were no significant differences in DFS and OS on surgical interventions. Increased risk of BOT recurrence was observed with positive washing cytology (adjusted hazard ratio (HR), 36.02; 95% confidence interval (CI), 6.798, 641.204; p = 0.003) and intraoperative iatrogenic rupture (adjusted HR, 5.89; 95% CI, 1.003, 27.640; p = 0.046), but no significant OS risk factors were identified. In early stage BOT treatment, surgical intervention differences didn’t affect outcomes, DFS or OS. Conservative, comprehensive and staging surgeries are options based on patient age and fertility preservation. To reduce BOT recurrence risk, avoiding rupture during surgery and closely monitoring postoperative patient with positive washing cytology is crucial.


Keywords

Borderline ovarian tumors; Conservative surgery; Comprehensive surgery; Staging surgery; Recurrence; Risk factors


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Seon-Mi Lee,Sanghoon Lee,Jae-Yun Song,Aeran Seol,Hyun-Woong Cho,Kyung-Jin Min,Jin-Hwa Hong,Jae-Kwan Lee,Nak-Woo Lee. Exploring the impact of surgical interventions and identifying risk factors for recurrence in stage I of borderline ovarian tumors. European Journal of Gynaecological Oncology. 2024. 45(2);75-87.

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