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Hum. Reprod. Advance Access originally published online on October 17, 2006
Human Reproduction 2007 22(2):578-585; doi:10.1093/humrep/del381
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: a randomized controlled study

S. Palomba1,5, E. Zupi2, T. Russo1, A. Falbo1, S. Del Negro1, F. Manguso3, D. Marconi2, A. Tolino4 and F. Zullo1

1 Department of Obstetrics and Gynecology, University ‘Magna Graecia’ of Catanzaro, Catanzaro 2 Department of Obstetrics and Gynecology, University ‘Tor Vergata’ of Rome, Rome 3 Department of Clinical and Experimental Medicine and 4 Department of Obstetrics and Gynecology, University ‘Federico II’ of Naples, Naples, Italy

5 To whom correspondence should be addressed at: Department of Gynecology and Obstetrics, University ‘Magna Graecia’ of Catanzaro, Via M. Greco 10, 88100 Catanzaro, Italy. E-mail: stefanopalomba{at}tin.it

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.

Key words: borderline ovarian tumour/cystectomy/fertility/recurrence/surgery


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