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Martin Koskas1, Catherine Uzan1, Sebastien Gouy1, Patricia Pautier2, Catherine Lhommé2, Christine Haie-Meder3, Pierre Duvillard4 and Philippe Morice1,5,*1Department of Gynecologic Surgery, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France 2Department of Oncology, Institut Gustave Roussy, Villejuif, France 3Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France 4Department of Pathology, Institut Gustave Roussy, Villejuif, France 5University Paris Sud, Institut Gustave Roussy, Villejuif, France *Correspondence address. Tel: +33-1-42-11-44-39; Fax: +33-1-42-11-52-13; E-mail: morice{at}igr.frReceived August 18, 2010. Revision received November 8, 2010. Accepted December 17, 2010. BACKGROUND The aim of this study was to define determinants of fertility in patients treated conservatively for mucinous borderline ovarian tumours (MBOTs), and to compare outcomes after salpingo-oophorectomy or cystectomy. METHODS This was a retrospective cohort study of fertility results in a series of patients treated conservatively for MBOTs and desiring pregnancy. Conservative surgery was defined as preservation of the uterus and ovarian tissue in one or both adnexa(e). Fertility results were compared with patients who had undergone a cystectomy or a (salpingo-)oophorectomy. Only patients with a minimum of 1 year of follow-up were included. Epidemiological, surgical, histological parameters and other prognostic factors for fertility results were investigated. RESULTS A group of 31 patients who had been treated conservatively between 1997 and 2004 and who desired pregnancy were investigated. Patients were treated by unilateral salpingo-oophorectomy (USO) (n = 19) or cystectomy (n = 12). The 5-year recurrence-free survival rate was higher in the USO group compared with the cystectomy group (94.7 versus 49.1%, P = 0.041). Among the 31 women, 12 had become pregnant. The 5-year probabilities of pregnancy were comparable between the cystectomy and salpingo-oophorectomy groups (41.8 and 45.9%, respectively, P= 0.66). None of the other factors studied (epidemiological, surgical and histological parameters) were associated with fertility results. CONCLUSIONS The use of salpingo-oophorectomy rather than cystectomy should be preferred during conservative surgery for patients with MBOTs because it decreases the risk of recurrence and does not impair fertility. © The Author 2011. 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@oup.com This ArticleHum. Reprod. (2011) 26 (4): 808-814. doi: 10.1093/humrep/deq399 First published online: January 24, 2011Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.
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