and 1 other(s)
One-third of borderline ovarian tumors (BOTs) involve in patients under 40 years of age. The question of the surgical management of these women becomes a real problem. Arcagy Gineco created in 2002 the Observatory of Rare Gynecological Malignant Neoplasms (TMRG) to supervise the management of rare gynecological tumors in national expert centers. The objectives of our study are to describe the management and fertility of patients under 45 years of age with BOTs based on TMRG data. This is a multicenter, retrospective study based on TMRG database data combined with questionnaire analysis of postoperative fertility. We collected data from 215 patients from 9 national centers reported to TMRG between 2010 and 2017. Unilateral adnexectomy was the most commonly performed intervention (49.7% of patients). Two factors independently associated with radical treatment were identified: age at diagnosis (> 38 years) (OR = 7.1, 95% CI [2.5-21.3], p <0.001) and higher anatomopathological stage FIGO (II-IV) (OR = 17.3, IC95 [4.9-69.7], p <0.001) in patients who received radical treatment. Among patients with a desire for postoperative pregnancy, 33 patients had a pregnancy (58%). The only factor associated with fertility found in this population was an antecedent of preoperative infertility (36.4% versus 9.1%, p = 0.036). The TMRG observatory provides a national and uniform management with the advice of national specialists. The analysis of this database gives us a reflection of the management in France of BOTs in women under 45 and the study of postoperative fertility is crucial in the management of BOTs
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