Is cystectomy an option as conservative surgery for young patients with borderline ovarian tumor? A multi‐institutional retrospective study
Abstract
Objective
To investigate the impact of cystectomy for borderline ovarian tumor (BOT) on tumor recurrence compared with salpingo‐oophorectomy using inverse probability of treatment weighting (IPTW).
Methods
A central pathologic review and a search of the medical records from 14 collaborating institutions from 1986 to 2017 identified 4708 women with a malignant ovarian neoplasm. Data for young women with Stage I BOT were extracted. To compare recurrence‐free survival between the surgery groups, Cox regression analyses and the IPTW‐adjusted Kaplan‐Meier method were employed.
Results
During a median follow‐up of 62.0 (1.2–270.4) months, 10 of the 285 patients identified (3.5%) developed recurrence. In multivariate analysis, the practice of cystectomy was not a significant prognostic indicator of recurrence‐free survival (hazard ratio [95% confidence interval] 1.276 [0.150–10.864]; P = 0.823). In the IPTW‐adjusted cohort, the 5‐year recurrence‐free survival rates were 95.8% and 96.0% in patients receiving cystectomy and salpingo‐oophorectomy, respectively (P = 0.378).
Conclusion
If patients are selected appropriately, cystectomy in itself may not increase tumor recurrence in young women with early‐stage BOT. A large‐scale prospective clinical study is necessary to validate this finding.