BORDERLINE TUMORS OF THE OVARY - FERTILITY TREATMENT, CONSERVATIVE MANAGEMENT, AND PREGNANCY OUTCOME

BACKGROUND. Ovarian tumors of borderline malignancy have a less aggres sive behavior and tend to occur at a younger age than their invasive c ounterparts. The role and extent of fertility-sparing conservative tre atments is under continuous evaluation. METHODS. The current study was a retrospective review of 82 patients with confirmed borderline tumor s diagnosed over a 25-year period, with special focus on fertility-ass ociated issues. RESULTS. Follow-up was available for 96% of the patien ts, for a total of 357 women-years of follow-up. Thirty-nine patients underwent conservative management. Of these, only three patients had a contralateral recurrence. Two of the three again opted for conservati ve management and were without evidence of disease at last follow-up. Seventeen patients did benefit from contralateral ovarian dissection e ither by cystectomy or oophorectomy because of contralateral benign or borderline disease. Eleven patients had received or were scheduled to receive ovulation induction. Five patients were diagnosed during the evaluation, and another two were diagnosed so soon after the initiatio n of ovulation induction that a causative relationship appeared to be unlikely. Six patients were diagnosed during ongoing pregnancies. Twen ty-two pregnancies were achieved in 15 patients after conservative tre atment. No influence of the disease or its treatment on the pregnancy (or vice versa) was observed during a mean follow-up of 69 months. CON CLUSIONS. Data are accumulating that indicate conservative fertility-s paring disease management is adequate treatment for patients with bord erline tumors. Available data indicate that in these patients fertilit y, pregnancy outcome, and survival remain excellent. (C) 1998 American Cancer Society.