Borderline ovarian tumors: retrospective study and literature review

Background: Borderline Ovarian tumor are epithelial tumors, diagnosed in early stage with excellent prognosis. The risk of recurrence is matter of concern. Methods: A retrospective, cross-sectional study conducted at OBGYN department of Aga khan hospital Karachi from 2002 to 2018. Results: Seventy-three patients with BOT were enrolled with mean age of 40 years. Fertility sparing surgery (FSS) was performed in 35 (48%) while 38 (52%) underwent debulking surgery. Average pre-operative CA-125 IU level was 47 in FSS and 40 in debulking group. Laparotomy was the commonest surgery in both groups with 5 (14%) patients in FSS group having laparoscopy. In debulking group, 3 patients (8%) had residual disease. Majority of patients in both groups had stage 1 disease i.e., 34 (97%) and 34 (89%) respectively. Serous was the most common histological type in both groups while unilateral lesions were prevalent in the FSS group (83% vs. 68%). Recurrence was reported in 3(8.6%) patients in FSS, while 1 (2.6%) in debulking group. Mean time to recurrence was 57.13 months. Amongst the 4 recurrences, 3 patients had FSS and had unilateral tumor, ruptured capsule or surface disease. They had mucinous histology with negative cytology. One from debulking group had recurrence with bilateral tumor, serous histology and stage IIIC. Three patients (9%) conceived in FSS and had live births. The 5-year overall survival was 97.9%. Conclusions: BOT have a favorable prognosis. Recurrences occur late in the trajectory of disease and hence regular follow-ups are important. They are common in mucinous tumors with external capsular involvement.