1145 Risk factors for recurrence of borderline ovarian tumors after conservative surgery: a multi center study by the francogyn group

Introduction/Background* Introduction: Borderline ovarian tumors (BOT) represent 10-20% of epithelial tumors of the ovary. Although their prognosis is excellent, the recurrence rate can be as high as 30%, and recurrence in the infiltrative form accounts for 3% to 5% of recurrences. Affecting one third of women of childbearing age, the surgical strategy with ovarian conservation is now recommended despite a significant risk of recurrence. Few studies have focused exclusively on patients who have received ovarian conservative treatment in an attempt to identify factors predictive of recurrence and the impact on fertility. The objective of this study was to identify the risk factors for recurrence of BOT after conservative treatment. Methodology This was a retrospective, multicentre study of women who received conservative surgery for BOT between February 1997 and September 2020. We divided the patients into two groups, the ”R group” with recurrence and the ”NR group” without recurrence. Result(s)* Of 175 patients analysed, 35 patients had a recurrence (R group, 20%) and 140 had no recurrence (NR group, 80%). With a mean follow-up of 30 months (IQ 8-62.5), the overall recurrence rate was 20%. Recurrence was BOT in 17.7% (31/175) and invasive in 2.3% (4/175). The mean time to recurrence was 29.5 months (IQ 16.5-52.5). Initial complete peritoneal staging (ICPS) was performed in 42.5% of patients (n=75). In multivariate analysis, age at diagnosis, nulliparity, advanced FIGO stage, the presence of peritoneal implants, and the presence of a micropapillary component for serous tumors were factors influencing the occurrence of recurrence. The post-surgery fertility rate was 67%. Conclusion* This multicentre study is to date one of the largest studies analysing the risk factors for recurrence of BOT after conservative surgery. Five risk factors were found: age at diagnosis, nulliparity, advanced FIGO stage and presence of implants, and a micropapillary component. Only 25% of the patients with recurrence underwent SPCI. These results reinforce the interest of an initial peritoneal staging in order not to ignore an advanced tumor stage.