Conservative management in young patients with borderline and malignant ovarian tumors: outcomes and pregnancies

Background: Recent studies have showed conservative management in selective patients with borderline and malignant ovarian tumors is safe; therefore this management is considered in patients with ovarian tumor who desire to preserve fertility. Objective: This study has been performed to evaluate the clinical outcome and fertility in patients with ovarian tumors who were treated conservatively. Materials and Methods: All patients who were treated conservatively (preservation of uterus and at least one ovary) or were on follow-up and had recurrence were evaluated in Vali-e-Asr Hospital during 2000-2004. Results: Among 410 patients with ovarian tumors, 60 were treated conservatively. Age range was 13-34 years. Twenty-six of patients (43.3%) were desired pregnancy and 34 (56%) patients did not. Three (5%) patients had history of infertility. Histological types of tumors were as follows; 15(25%) borderline tumors, 10(16.7%) epithelial tumors, 26(43.3%) germ cell tumors, and 9(15%) sex cord tumors. Range of follow-up time was 12-48 months. Seven term pregnancies in 6 patients had been occurred, 1 in epithelial group, 2 in germ cell group, 1 in sex cord group and 3 in borderline group. Nine patients had recurrence and 2 patients expired, including one patient with serous cyst carcinoma (Stage IIIC).This patient had refused radical surgery and referred to our center with recurrence. Another patient had immature teratoma (Stage IIIC). Conclusion: Conservative surgical management in young patients with stage I (grade 1, 2) of epithelial ovarian tumor and sex cord-stromal tumor and in patients with borderline and germ cell ovarian tumors could be performed in order to preserve fertility.