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

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.

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

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