Unilateral cystectomy and serous histology are associated with relapse in borderline ovarian tumor patients with fertili
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REVIEW
Unilateral cystectomy and serous histology are associated with relapse in borderline ovarian tumor patients with fertility‑sparing surgery: a systematic review and meta‑analysis Na Li1,2 · Xiu Ming1 · Zhengyu Li1 Received: 9 October 2019 / Accepted: 27 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Surgical procedures, histological subtypes, and surgical approaches are involved in the recurrence of borderline ovarian tumors (BOTs), but whether those three factors affect relapse remains controversial. This study aimed to explore the effects of surgical procedures, histological subtypes, and surgical approaches on the relapse and pregnancy rates of BOT after fertility-preserving surgery (FPS) according to the patients’ characteristics. Methods A systematic search of PubMed, Embase, and the Cochrane library was conducted from their inception to November 2018. Studies that investigated the impact of surgical procedures, histological subtypes, and surgical approaches on the relapse and pregnancy rates in patients with BOT after FPS were eligible. The pooled odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) were calculated using the random-effects model. Results Thirty-five studies involving a total of 2921 patients with BOT after FPS were included. The pooled ORs indicated that the risk of relapse was significantly increased in patients who underwent unilateral cystectomy or with serous BOT. There was no significant difference between laparoscopy and laparotomy on the risk of relapse. Surgical procedures, histological subtypes, and surgical approaches did not influence pregnancy rates. Conclusions Patients who underwent unilateral cystectomy or with serous BOT presented an excess risk of relapse after FPS, but the surgical approach did not affect the risk of relapse. The pregnancy rate is not affected by surgical procedures, histological subtypes, and surgical approaches. Keywords Borderline ovarian tumors · Fertility-preserving surgery · Pregnancy outcome · Meta-analysis
Introduction
Na Li and Xiu Ming contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00404-020-05716-x) contains supplementary material, which is available to authorized users. * Zhengyu Li [email protected] 1
Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, People’s Republic of China
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zunyi Medical University, Zunyi 563000, People’s Republic of China
2
Borderline ovarian tumors (BOTs) account for 10–20% of the epithelial ovarian malignant neoplasms, and the incidence of BOTs is 1.8–4.8 per 100,000 females/year [1]. The characteristics of BOTs include nuclear abnormalities, increased mitotic activity, and no stromal invasion [2]. The two main histologi
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