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The Oncological Follow-Up of Fertility Sparing Surgery for Mucinous Borderline Ovarian Tumours: A Retrospective Cohort Study
by
, , and
Nicholas Anson
1,*,
Patricia Cox
2,
Lorraine S. Kasaven
1,
Chiara Landolfo
2,3,
Maya Al-Memar
2,
Benjamin P. Jones
2,4,
Srdjan Saso
1,
Mona El-Bahrawy
5,
Sadaf Ghaem-Maghami
1 and
Joseph Yazbek
1 1
Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
2
Queen Charlotte’s and Chelsea Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK
3
Department of Metabolism, Digestion & Reproduction, Faculty of Medicine, Imperial College London, London W2 1NY, UK
4
The Lister Fertility Clinic, The Lister Hospital, Chelsea Bridge Road, London SW1W 8RH, UK
5
Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
*
Author to whom correspondence should be addressed.
Cancers 2025, 17(23), 3825; https://doi.org/10.3390/cancers17233825 (registering DOI)
Submission received: 5 October 2025
/
Revised: 20 November 2025
/
Accepted: 26 November 2025
/
Published: 28 November 2025
(This article belongs to the Section Clinical Research of Cancer)
Simple Summary
Young women with suspected mucinous borderline ovarian tumours, a type of ovarian cyst, require surgery. Due to the large size and nature of these lesions, removal of the entire ovary and fallopian tube is typically required and recommended; however, some patients undergo surgery to remove the cyst alone. Following surgery, patients undergo long-term follow-up with ultrasound imaging as surveillance for disease recurrence. We set out to determine if this long-term follow-up is required in all patients. Our results indicate that, in patients who have undergone removal of the ovary and fallopian tube, the risk of recurrence is very low and therefore we suggest these patients can be offered a reduced follow-up schedule. For patients treated with removal of the cyst alone, there is a higher chance of disease recurrence and therefore these patients should undergo long-term follow-up as is currently practiced.
Abstract
Background/Objectives: To determine whether long-term oncological follow-up is required following fertility-sparing surgery (FSS) for mucinous borderline ovarian tumours (MBOTs). Methods: A retrospective cohort study set in the tertiary gynaecology oncology centre at Imperial College Healthcare NHS Trust. Patients included were those under follow-up post-surgery for an MBOT in the ovarian clinic from 2007 to 2025. Rate of recurrence was compared amongst patients who underwent ovarian cystectomy, unilateral salpingo-oophorectomy (USO) or bilateral salpingo-oophorectomy (BSO) +/− hysterectomy. Results: From 74 patients diagnosed with MBOT, 36.5% (27/74) underwent BSO +/− hysterectomy and 63.5% (47/74) had FSS. Of the patients who underwent FSS, 59.6% (28/47) had an initial USO and 40.4% (19/47) underwent ovarian cystectomy. Subsequently, 63.2% (12/19) of patients who initially had ovarian cystectomy proceeded with completion USO, leading to a total of 40 USOs performed. There were no recurrences following BSO +/− hysterectomy, primary USO or completion USO after a median follow-up of 49.0, 65.5 and 48.0 months, respectively. Of the patients who underwent ovarian cystectomy, 15.8% (3/19) were found to have residual MBOT (n = 1) two months post-cystectomy or MBOT recurrence (n = 2) at 10- and 66-months post-cystectomy, all diagnosed at USO. There is a significant association between ovarian cystectomy and disease recurrence (Fisher’s exact test p = 0.015). Conclusions: Patients of reproductive age who undergo USO for a MBOT can be offered a reduced follow-up schedule as the risk of recurrence is very low. In contrast, patients who are managed by ovarian cystectomy have a higher risk of recurrence and require long-term surveillance monitoring.
