Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: a randomized controlled study
Authors: Palomba, S.; Zupi, E.; Russo, T.; Falbo, A.; Del Negro, S.; Manguso, F.; Marconi, D.; Tolino, A.; Zullo, F.
Source: Human Reproduction, Volume 22, Number 2, February 2007 , pp. 578-585(8)
Publisher: Oxford University Press
Abstract:BACKGROUND: During the childbearing years, the standard fertility-sparing treatment for bilateral borderline ovarian tumours (BOTs) is the unilateral oophorectomy plus controlateral cystectomy. The aim of the present study was to compare the effects of two laparoscopic fertility-sparing surgical procedures for the treatment of bilateral BOTs on recurrence and fertility in young women who desire to conceive as soon as possible. METHODS: Thirty-two women affected by bilateral early-stage BOTs who desired to conceive were randomized to receive bilateral cystectomy (experimental group, n = 15) or oophorectomy plus controlateral cystectomy (control group, n = 17). At the first recurrence after childbearing completion, each patient was treated with non-conservative standard treatment. Recurrences and reproductive events were recorded. RESULTS: After a follow-up period of 81 months (19 inter-quartile; 60–96 range), the cumulative pregnancy rate (CPR) (14/15 versus 9/17; P = 0.003) and the cumulative probability of first pregnancy (P = 0.011) were significantly higher in the experimental than in control group. No significant (P = 0.358) difference between groups was detected in cumulative probability of first recurrence. CONCLUSIONS: The laparoscopic bilateral cystectomy followed by non-conservative treatment performed at the first recurrence after the childbearing completion is an effective surgical strategy for patients with bilateral early-stage BOTs who desire to conceive as soon as possible.
Document Type: Research Article
Publication date: February 2007
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.