Skip to main content
SpringerLink
Log in

Unilateral cystectomy and serous histology are associated with relapse in borderline ovarian tumor patients with fertility-sparing surgery: a systematic review and meta-analysis

  • Review
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Trillsch F, Ruetzel JD, Herwig U, Doerste U, Woelber L, Grimm D, Choschzick M, Jaenicke F, Mahner S (2013) Surgical management and perioperative morbidity of patients with primary borderline ovarian tumor (BOT). J Ovarian Res 6(1):48. https://doi.org/10.1186/1757-2215-6-48

    Article  PubMed  PubMed Central  Google Scholar 

  2. Taylor HC (1929) Malignant and semimalignant tumors of the ovary. Surg Gynecol Obstet 48:204–230

    Google Scholar 

  3. Seidman JD, Soslow RA, Vang R, Berman JJ, Stoler MH, Sherman ME, Oliva E, Kajdacsy-Balla A, Berman DM, Copeland LJ (2004) Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrative images. Hum Pathol 35(8):918–933

    Article  Google Scholar 

  4. Serov SF, Scully RE, Sobin LH (1973) Histologic typing of ovarian tumors in international histologic classification of tumors, vol 9. World Health Organization, Geneva

    Google Scholar 

  5. Morice P (2006) Borderline tumours of the ovary and fertility. Eur J Cancer (Oxf, Engl: 1990) 42(2):149–158. https://doi.org/10.1016/j.ejca.2005.07.029

    Article  CAS  Google Scholar 

  6. Akeson M, Zetterqvist BM, Dahllof K, Jakobsen AM, Brannstrom M, Horvath G (2008) Population-based cohort follow-up study of all patients operated for borderline ovarian tumor in western Sweden during an 11-year period. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 18(3):453–459. https://doi.org/10.1111/j.1525-1438.2007.01051.x

    Article  CAS  Google Scholar 

  7. Vasconcelos I, de Sousa Mendes M (2015) Conservative surgery in ovarian borderline tumours: a meta-analysis with emphasis on recurrence risk. Eur J Cancer (Oxf, Engl: 1990) 51(5):620–631. https://doi.org/10.1016/j.ejca.2015.01.004

    Article  Google Scholar 

  8. Trillsch F, Mahner S, Woelber L, Vettorazzi E, Reuss A, Ewald-Riegler N, de Gregorio N, Fotopoulou C, Schmalfeldt B, Burges A, Hilpert F, Fehm T, Meier W, Hillemanns P, Hanker L, Hasenburg A, Strauss HG, Hellriegel M, Wimberger P, Baumann K, Keyver-Paik MD, Canzler U, Wollschlaeger K, Forner D, Pfisterer J, Schroeder W, Muenstedt K, Richter B, Kommoss F, Hauptmann S, du Bois A (2014) Age-dependent differences in borderline ovarian tumours (BOT) regarding clinical characteristics and outcome: results from a sub-analysis of the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) ROBOT study. Ann Oncol Off J Eur Soc Med Oncol 25(7):1320–1327. https://doi.org/10.1093/annonc/mdu119

    Article  CAS  Google Scholar 

  9. Novikova EG, Shevchuk AS (2014) Organ-sparing therapy for patients with borderline ovarian tumors. Vopr Onkol 60(3):267–273

    CAS  PubMed  Google Scholar 

  10. Karlsen NMS, Karlsen MA, Hogdall E, Nedergaard L, Christensen IJ, Hogdall C (2016) Relapse and disease specific survival in 1143 Danish women diagnosed with borderline ovarian tumours (BOT). Gynecol Oncol 142(1):50–53. https://doi.org/10.1016/j.ygyno.2016.05.005

    Article  PubMed  Google Scholar 

  11. Morris RT, Gershenson DM, Silva EG, Follen M, Morris M, Wharton JT (2000) Outcome and reproductive function after conservative surgery for borderline ovarian tumors. Obstet Gynecol 95(4):541–547

    CAS  PubMed  Google Scholar 

  12. Fischerova D, Zikan M, Dundr P, Cibula D (2012) Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist 17(12):1515–1533. https://doi.org/10.1634/theoncologist.2012-0139

    Article  PubMed  PubMed Central  Google Scholar 

  13. Vancraeynest E, Moerman P, Leunen K, Amant F, Neven P, Vergote I (2016) Fertility preservation is safe for serous borderline ovarian tumors. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 26(8):1399–1406. https://doi.org/10.1097/igc.0000000000000782

    Article  Google Scholar 

  14. Helpman L, Yaniv A, Beiner ME, Aviel-Ronen S, Perri T, Ben-Baruch G, Hogen Ben-David L, Jakobson-Setton A, Korach J (2017) Fertility preservation in women with borderline ovarian tumors—how does it impact disease outcome? A cohort study. Acta Obstet Gynecol Scand 96(11):1300–1306. https://doi.org/10.1111/aogs.13203

    Article  PubMed  Google Scholar 

  15. Romeo M, Pons F, Barretina P, Radua J (2013) Incomplete staging surgery as a major predictor of relapse of borderline ovarian tumor. World J Surg Oncol 11:13. https://doi.org/10.1186/1477-7819-11-13

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ricciardi E, Baert T, Ataseven B, Heitz F, Prader S, Bommert M, Schneider S, du Bois A, Harter P (2018) Low-grade serous ovarian carcinoma. Geburtshilfe Frauenheilkd 78(10):972–976. https://doi.org/10.1055/a-0717-5411

    Article  PubMed  PubMed Central  Google Scholar 

  17. Prat J, De Nictolis M (2002) Serous borderline tumors of the ovary: a long-term follow-up study of 137 cases, including 18 with a micropapillary pattern and 20 with microinvasion. Am J Surg Pathol 26(9):1111–1128

    Article  Google Scholar 

  18. Deavers MT, Gershenson DM, Tortolero-Luna G, Malpica A, Lu KH, Silva EG (2002) Micropapillary and cribriform patterns in ovarian serous tumors of low malignant potential: a study of 99 advanced stage cases. Am J Surg Pathol 26(9):1129–1141

    Article  Google Scholar 

  19. Morice P, Camatte S, Rey A, Atallah D, Lhomme C, Pautier P, Pomel C, Cote JF, Haie-Meder C, Duvillard P, Castaigne D (2003) Prognostic factors for patients with advanced stage serous borderline tumours of the ovary. Ann Oncol Off J Eur Soc Med Oncol 14(4):592–598

    Article  CAS  Google Scholar 

  20. Longacre TA, McKenney JK, Tazelaar HD, Kempson RL, Hendrickson MR (2005) Ovarian serous tumors of low malignant potential (borderline tumors): outcome-based study of 276 patients with long-term (> or = 5-year) follow-up. Am J Surg Pathol 29(6):707–723

    Article  Google Scholar 

  21. Wu TI, Lee CL, Wu MY, Hsueh S, Huang KG, Yeh CJ, Lai CH (2009) Prognostic factors predicting recurrence in borderline ovarian tumors. Gynecol Oncol 114(2):237–241. https://doi.org/10.1016/j.ygyno.2009.05.018

    Article  CAS  PubMed  Google Scholar 

  22. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012

    Article  CAS  Google Scholar 

  23. Wells MG, Shea BO, Connell D (2009) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute. http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed Nov 2018

  24. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    Article  CAS  Google Scholar 

  25. Ades AE, Lu G, Higgins JP (2005) The interpretation of random-effects meta-analysis in decision models. Med Decis Mak Int J Soc Med Decis Mak 25(6):646–654. https://doi.org/10.1177/0272989x05282643

    Article  CAS  Google Scholar 

  26. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ (Clin Res Ed) 327(7414):557–560. https://doi.org/10.1136/bmj.327.7414.557

    Article  Google Scholar 

  27. Tobias A (1999) Assessing the influence of a single study in meta-analysis. Stata Tech Bull 47:15–17

    Google Scholar 

  28. Thompson SG, Higgins JP (2002) How should meta-regression analyses be undertaken and interpreted? Stat Med 21(11):1559–1573. https://doi.org/10.1002/sim.1187

    Article  PubMed  Google Scholar 

  29. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ (Clin Res Ed) 315(7109):629–634

    Article  CAS  Google Scholar 

  30. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101

    Article  CAS  Google Scholar 

  31. Ji H, Yliskoski M, Anttila M, Syrjanen K, Saarikoski S (1996) Management of stage-I borderline ovarian tumors. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 54(1):37–44

    Article  CAS  Google Scholar 

  32. Tamakoshi K, Kikkawa F, Nakashima N, Tamakoshi A, Kawai M, Furuhashi Y, Hattori SE, Kuzuya K, Arii Y, Suganuma N, Tomoda Y (1997) Clinical behavior of borderline ovarian tumors: a study of 150 cases. J Surg Oncol 64(2):147–152

    Article  CAS  Google Scholar 

  33. Beiner ME, Gotlieb WH, Davidson B, Kopolovic J, Ben-Baruch G (2001) Infertility treatment after conservative management of borderline ovarian tumors. Cancer 92(2):320–325

    Article  CAS  Google Scholar 

  34. Morice P, Camatte S, El Hassan J, Pautier P, Duvillard P, Castaigne D (2001) Clinical outcomes and fertility after conservative treatment of ovarian borderline tumors. Fertil Steril 75(1):92–96

    Article  CAS  Google Scholar 

  35. Zanetta G, Rota S, Chiari S, Bonazzi C, Bratina G, Mangioni C (2001) Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol Off J Am Soc Clin Oncol 19(10):2658–2664. https://doi.org/10.1200/jco.2001.19.10.2658

    Article  CAS  Google Scholar 

  36. Boran N, Cil AP, Tulunay G, Ozturkoglu E, Koc S, Bulbul D, Kose MF (2005) Fertility and recurrence results of conservative surgery for borderline ovarian tumors. Gynecol Oncol 97(3):845–851. https://doi.org/10.1016/j.ygyno.2005.03.010

    Article  PubMed  Google Scholar 

  37. Rao GG, Skinner EN, Gehrig PA, Duska LR, Miller DS, Schorge JO (2005) Fertility-sparing surgery for ovarian low malignant potential tumors. Gynecol Oncol 98(2):263–266. https://doi.org/10.1016/j.ygyno.2005.04.025

    Article  PubMed  Google Scholar 

  38. Suh-Burgmann E (2006) Long-term outcomes following conservative surgery for borderline tumor of the ovary: a large population-based study. Gynecol Oncol 103(3):841–847. https://doi.org/10.1016/j.ygyno.2006.05.014

    Article  PubMed  Google Scholar 

  39. Poncelet C, Fauvet R, Boccara J, Darai E (2006) Recurrence after cystectomy for borderline ovarian tumors: results of a French multicenter study. Ann Surg Oncol 13(4):565–571. https://doi.org/10.1245/aso.2006.12.024

    Article  PubMed  Google Scholar 

  40. Romagnolo C, Gadducci A, Sartori E, Zola P, Maggino T (2006) Management of borderline ovarian tumors: results of an Italian multicenter study. Gynecol Oncol 101(2):255–260. https://doi.org/10.1016/j.ygyno.2005.10.014

    Article  PubMed  Google Scholar 

  41. Yokoyama Y, Moriya T, Takano T, Shoji T, Takahashi O, Nakahara K, Yamada H, Yaegashi N, Okamura K, Izutsu T, Sugiyama T, Tanaka T, Kurachi H, Sato A, Tase T, Mizunuma H (2006) Clinical outcome and risk factors for recurrence in borderline ovarian tumours. Br J Cancer 94(11):1586–1591. https://doi.org/10.1038/sj.bjc.6603139

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Tinelli FG, Tinelli R, La Grotta F, Tinelli A, Cicinelli E, Schonauer MM (2007) Pregnancy outcome and recurrence after conservative laparoscopic surgery for borderline ovarian tumors. Acta Obstet Gynecol Scand 86(1):81–87. https://doi.org/10.1080/00016340600994596

    Article  CAS  PubMed  Google Scholar 

  43. Wong HF, Low JJ, Chua Y, Busmanis I, Tay EH, Ho TH (2007) Ovarian tumors of borderline malignancy: a review of 247 patients from 1991 to 2004. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 17(2):342–349. https://doi.org/10.1111/j.1525-1438.2007.00864.x

    Article  CAS  Google Scholar 

  44. Yinon Y, Beiner ME, Gotlieb WH, Korach Y, Perri T, Ben-Baruch G (2007) Clinical outcome of cystectomy compared with unilateral salpingo-oophorectomy as fertility-sparing treatment of borderline ovarian tumors. Fertil Steril 88(2):479–484. https://doi.org/10.1016/j.fertnstert.2006.11.128

    Article  PubMed  Google Scholar 

  45. De Iaco P, Ferrero A, Rosati F, Melpignano M, Biglia N, Rolla M, De Aloysio D, Sismondi P (2009) Behaviour of ovarian tumors of low malignant potential treated with conservative surgery. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 35(6):643–648. https://doi.org/10.1016/j.ejso.2008.09.011

    Article  Google Scholar 

  46. Kokawa K, Mikami Y, Sakata H, Oki N, Tanakas T, Yamazaki M, Nakata Y, Umesaki N (2009) Clinical outcome and prognostic factors in borderline tumors of the ovary. Results from 17 years’ experience in the Kinki District of Japan (1990–2006). Eur J Gynaecol Oncology 30(2):155–161

    CAS  Google Scholar 

  47. Park JY, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH (2009) Surgical management of borderline ovarian tumors: the role of fertility-sparing surgery. Gynecol Oncol 113(1):75–82. https://doi.org/10.1016/j.ygyno.2008.12.034

    Article  PubMed  Google Scholar 

  48. Benito V, Lubrano A, Arencibia O, Medina N, Álvarez Eva E, Andújar M, Falcón Juan M, Falcón O (2010) Serous and mucinous borderline ovarian tumors: are there real differences between these two entities? Eur J Obstet Gynecol Reprod Biol 153(2):188–192. https://doi.org/10.1016/j.ejogrb.2010.07.024

    Article  PubMed  Google Scholar 

  49. Uzan C, Kane A, Rey A, Gouy S, Duvillard P, Morice P (2010) Outcomes after conservative treatment of advanced-stage serous borderline tumors of the ovary. Ann Oncol Off J Eur Soc Med Oncol 21(1):55–60. https://doi.org/10.1093/annonc/mdp267

    Article  CAS  Google Scholar 

  50. Kanat-Pektas M, Ozat M, Gungor T, Dikici T, Yilmaz B, Mollamahmutoglu L (2011) Fertility outcome after conservative surgery for borderline ovarian tumors: a single center experience. Arch Gynecol Obstet 284(5):1253–1258. https://doi.org/10.1007/s00404-010-1804-7

    Article  PubMed  Google Scholar 

  51. Anfinan N, Sait K, Ghatage P, Nation J, Chu P (2011) Ten years experience in the management of borderline ovarian tumors at Tom Baker Cancer Centre. Arch Gynecol Obstet 284(3):731–735. https://doi.org/10.1007/s00404-010-1713-9

    Article  PubMed  Google Scholar 

  52. Khunamornpong S, Settakorn J, Sukpan K, Suprasert P, Siriaunkgul S (2011) Mucinous tumor of low malignant potential (“borderline” or “atypical proliferative” tumor) of the ovary: a study of 171 cases with the assessment of intraepithelial carcinoma and microinvasion. Int J Gynecol Pathol Off J Int Soc Gynecol Pathol 30(3):218–230. https://doi.org/10.1097/PGP.0b013e3181fcf01a

    Article  Google Scholar 

  53. Song T, Hun Choi C, Lee YY, Kim TJ, Lee JW, Bae DS, Kim BG (2011) Oncologic and reproductive outcomes of cystectomy compared with oophorectomy as a treatment for borderline ovarian tumours. Hum Reprod (Oxf, Engl) 26(8):2008–2014. https://doi.org/10.1093/humrep/der119

    Article  Google Scholar 

  54. Tsai HW, Ko CC, Yeh CC, Chen YJ, Twu NF, Chao KC, Yen MS (2011) Unilateral salpingo-oophorectomy as fertility-sparing surgery for borderline ovarian tumors. J Chin Med Assoc 74(6):250–254. https://doi.org/10.1016/j.jcma.2011.04.003

    Article  PubMed  Google Scholar 

  55. Ferrero A, Strada I, Di Marcoberardino B, Maccarini LR, Pozzati F, Rossi M, Biglia N, De Iaco P (2012) Clinical significance of microinvasion in borderline ovarian tumors and its impact on surgical management. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 22(7):1158–1162. https://doi.org/10.1097/IGC.0b013e31825e5254

    Article  Google Scholar 

  56. Uzan C, Muller E, Kane A, Rey A, Gouy S, Bendiffallah S, Duvillard P, Fauvet R, Darai E, Morice P (2014) Prognostic factors for recurrence after conservative treatment in a series of 119 patients with stage I serous borderline tumors of the ovary. Ann Oncol Off J Eur Soc Med Oncol 25(1):166–171. https://doi.org/10.1093/annonc/mdt430

    Article  CAS  Google Scholar 

  57. Chen RF, Li J, Zhu TT, Yu HL, Lu X (2016) Fertility-sparing surgery for young patients with borderline ovarian tumors (BOTs): single institution experience. J Ovarian Res 9:16. https://doi.org/10.1186/s13048-016-0226-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Ureyen I, Karalok A, Tasci T, Turkmen O, Boran N, Tulunay G, Turan T (2016) The factors predicting recurrence in patients with serous borderline ovarian tumor. Int J Gynecol Cancer Off J Inte Gynecol Cancer Soc 26(1):66–72. https://doi.org/10.1097/igc.0000000000000568

    Article  Google Scholar 

  59. Chang C, Chen J, Chen WA, Ho SP, Liou WS, Chiang AJ (2017) Assessing the risk of clinical and pathologic factors for relapse of borderline ovarian tumours. J Obstet Gynaecol J Inst Obstet Gynaecol 37(2):233–237. https://doi.org/10.1080/01443615.2016.1244810

    Article  Google Scholar 

  60. Chen X, Fang C, Zhu T, Zhang P, Yu A, Wang S (2017) Identification of factors that impact recurrence in patients with borderline ovarian tumors. J Ovarian Res 10(1):23. https://doi.org/10.1186/s13048-017-0316-5

    Article  PubMed  PubMed Central  Google Scholar 

  61. Lee SY, Choi MC, Kwon BR, Jung SG, Park H, Joo WD, Lee C, Lee JH, Lee JM (2017) Oncologic and obstetric outcomes of conservative surgery for borderline ovarian tumors in women of reproductive age. Obstet Gynecol Sci 60(3):289–295. https://doi.org/10.5468/ogs.2017.60.3.289

    Article  PubMed  PubMed Central  Google Scholar 

  62. Fang C, Zhao L, Chen X, Yu A, Xia L, Zhang P (2018) The impact of clinicopathologic and surgical factors on relapse and pregnancy in young patients (≤ 40 years old) with borderline ovarian tumors. BMC Cancer 18(1):1147. https://doi.org/10.1186/s12885-018-4932-2

    Article  PubMed  PubMed Central  Google Scholar 

  63. Cadron I, Amant F, Van Gorp T, Neven P, Leunen K, Vergote I (2006) The management of borderline tumours of the ovary. Curr Opin Oncol 18(5):488–493. https://doi.org/10.1097/01.cco.0000239889.98289.ce

    Article  PubMed  Google Scholar 

  64. Jiao X, Hu J, Zhu L (2017) Prognostic factors for recurrence after fertility-preserving surgery in patients with borderline ovarian tumors: a systematic review and meta-analysis of observational studies. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 27(9):1833–1841. https://doi.org/10.1097/igc.0000000000001092

    Article  Google Scholar 

  65. Tinelli R, Tinelli A, Tinelli FG, Cicinelli E, Malvasi A (2006) Conservative surgery for borderline ovarian tumors: a review. Gynecol Oncol 100(1):185–191. https://doi.org/10.1016/j.ygyno.2005.09.021

    Article  PubMed  Google Scholar 

  66. Morice P, Uzan C, Fauvet R, Gouy S, Duvillard P, Darai E (2012) Borderline ovarian tumour: pathological diagnostic dilemma and risk factors for invasive or lethal recurrence. Lancet Oncol 13(3):e103–e115. https://doi.org/10.1016/s1470-2045(11)70288-1

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Author notes

  1. Na Li and Xiu Ming contributed equally to this work.

Authors and Affiliations

  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

    Na Li, Xiu Ming & Zhengyu Li

  2. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, People’s Republic of China

    Na Li

Authors
  1. Na Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiu Ming
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhengyu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NL and XM carried out the studies, participated in collecting data, and drafted the manuscript. NL and ZYL performed the statistical analysis and participated in its design. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zhengyu Li.

Ethics declarations

Ethics approval

This is a meta-analysis. The data in the article are from published articles, so no ethical approval was required.

Conflict of interest

All authors declare that they have no conflict of interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 18 kb)

Figure S1. Sensitivity analysis for UC versus USO on the risk of relapse (TIFF 655 kb)

Figure S2. Sensitivity analysis for serous versus mucinous BOT patients on the risk of relapse (TIFF 453 kb)

Figure S3. Sensitivity analysis for laparoscopy versus laparotomy on the risk of relapse (TIFF 459 kb)

Figure S4. Funnel plot for UC versus USO on the risk of relapse (TIFF 92 kb)

Figure S5. Funnel plot for serous versus mucinous BOT patients on the risk of relapse (TIFF 86 kb)

Figure S6. Funnel plot for laparoscopy versus laparotomy on the risk of relapse (TIFF 80 kb)

Figure S7. Result for UC vs. USO on the incidence of pregnancies in BOT patients after FPS. (TIFF 92 kb)

Figure S8. Result for serous vs. mucinous on the incidence of pregnancies in BOT (TIFF 96 kb)

404_2020_5716_MOESM10_ESM.tif

Figure S9. The summary result for laparoscopy vs. laparotomy on the incidence of pregnancies in BOT patients after FPS. (TIFF 80 kb)

Supplementary material 11 (DOCX 19 kb)

Supplementary material 12 (DOCX 15 kb)

Supplementary material 13 (DOCX 14 kb)

Supplementary material 14 (DOCX 13 kb)

Supplementary material 15 (DOCX 13 kb)

Supplementary material 16 (DOCX 12 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, N., Ming, X. & Li, Z. Unilateral cystectomy and serous histology are associated with relapse in borderline ovarian tumor patients with fertility-sparing surgery: a systematic review and meta-analysis. Arch Gynecol Obstet 302, 1063–1074 (2020). https://doi.org/10.1007/s00404-020-05716-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05716-x

Keywords

Search

Navigation