Evidence-based Clinical Research In The Fertility-sparing Surgery Of Borderline Ovarian Tumor

Objective: To analyze the fertility rate, tumor recurrence rate andsurvival rate after conservative management of the women withborderline ovarian tumors.Material and Method: Database Systems include Pubmed, Medline,Embase, Cochrane, CNKI, Wanfang, Weipu were searched for relevantliteratures in English and Chinese which were publishedduring1990.01.01-2014.03.01. Used Revman5.2.7software of Cochranecollaboration test statistical methods to calculate and compare overallsurvival between fertility-sparing group and not fertility-sparing group,and their recurrence rate were compared and also analyzed the fertilitypotential.Results: The search strategy was adapted accordingly. From the results ofthe searches, relevant articles were identified and scanned. Any newterms found were fed into the search strategy, and new searches weredone. The reference lists of the relevant papers found were scrutinized forfurther studies. Overall,14studies met the inclusion criteria. From thesestudies, total2244patients had borderline ovarian tumors of which948(42%) patients were treated by conservative surgery. Among them onestudy was prospective study，the other13studies were retrospective casecontrol studies. According to the data collected, Meta analysis (or statistical analysis) was done. The results are as follows, the totalsurvival rates after conservative treatment were higher than radicalsurgery group （OR=2.15，95%CI （1.09,4.23）， P=0.03）. Nodifference was noted in recurrence of BOT diagnosed at stage I(OR=1.86，95%CI(0.57,6.06),although P=0.3)。Recurrence rates weresignificantly higher in conservative surgery group(OR=3.85，95%CI(2.62,5.68)， P＜0.00001);9studies reported data regardingpregnancy outcome.4studies were analysed for the number of womendesiring to conceive and the actual number of pregnancies achieved. Apregnancy rate of55.6%was calculated from these data.Conclusion This study confirms that conservative surgery is a preferableoption for patients wishing to retain their fertility potential although therecurrence rate is high. Compared to radical operation, fertility-sparingconservative surgery will not reduce the survival rate of patients and hasan adverse prognosis, and also is the mainstay of treatment, asconservative surgery where fertility is desired if the family is complete.