Borderline ovarian tumours in a middle-income country setting: a 10-yearretrospective review of cases in a tertiary hospital in South Africa

Abstract

Background: The diagnosis and management of borderline ovarian tumours (BOT) remain controversial almost a century after their initial description. Little research has been done in Africa to provide answers on the prevalence and outcomes of these tumours. This study reviewed cases of BOTs at Groote Schuur Hospital over 10 years.

Methods: A retrospective review of women diagnosed with BOTs at Groote Schuur Hospital between January 2005 and December 2014 was undertaken. Women with multiple primary tumours, who were lost to follow-up or had inadequate clinical data, were excluded. Demographic characteristics, preoperative, operative, postoperative, oncological, and pathological data were retrieved and analysed.

Results: In the study period, 91 patients were diagnosed with BOTs. Of these, 19 were eliminated, and 72 were analysed. BOTs accounted for 22.3% of the 409 ovarian neoplasms. Fertility-sparing surgery was done in 31.9% (n = 23). Mucinous histology was the most common histological subtype (57%). Our overall recurrence rate was 13.9% (n = 10), with 40% being invasive (n = 4). The five-year overall survival (OS) rate was 91.7%, and the five-year relapse-free survival (RFS) rate was 89.9%. Despite small numbers, all patients with invasive recurrence died within five years of recurrence, while all patients who recurred with borderline histology were alive five years after recurrence.

Conclusion: Mucinous histology was the most common histological subtype (57%). Despite BOTs having a generally favourable prognosis, patients who recurred with invasive disease were all dead five years after recurrence. Patients who recurred with borderline histology were all alive five years after recurrence.