الفهرس 
Chapter (1): EPIDEMIOLOGY AND RISK FACTORS.Only 14 pages are availabe for public view
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Abstract
with a favorable prognosis. BOTs are histologically distinguished from ovarian carcinomas by the absence of stromal invasion.
Our study was performed to identify the clinicopathological features and modalities of treatment affecting the surgical outcome and survival in women treated for Borderline Ovarian Tumors.
Data of 92 patients diagnosed with borderline ovarian tumors (BOTs) during the period from March 2005 to February 2017 in the National Cancer Institute (NCI), Cairo University, Egypt were retrospectively evaluated using the database of the Pathology Department.
The mean follow-up period was 76 months (range, 12-157 months). The mean age at diagnosis was 42.7 yrs. Histopathology was serous in 63%, mucinous in 28.3%, and endometrioid in 3.3%. Sixty-five patients (70.7%) had stage IA disease, 17 patients had stage IB disease (18.5%), 4 patients had stage IC disease (4.3%), 2 patients had stage II disease (2.2%) and 4 patients had stage III disease (4.3%) at diagnosis .Forty-nine patients (53.3%) underwent fertility sparing surgery, of which 19 patients underwent unilateral ovarian cystectomy, 5 patients underwent bilateral ovarian cystectomy, 25 underwent unilateral salpingo-oophorectomy. Forty-three patients (46.7%) underwent radical surgery including hysterectomy, bilateral salpingo-oophorectomy. Thirty-nine patients had micropapillary disease (42 %) and two patients had microinvasive disease (2.2%) on histopathology. Six patients (6.5 %) had peritoneal implants of which 1 was invasive and 5 were non-invasive. Recurrence rate in the entire study group was 18.5%, 17.6% among patients underwent radical surgery and 82.4% among patients underwent fertility sparing surgery. Twelve of the recurrences (70.6%) were borderline whereas five were invasive (29.4%).Radical surgery had significantly higher disease-free survival than fertility sparing surgery (75.8 months Vs 68.5months). Within the fertility sparing surgery group, patients with elevated CA-125 more than 35 IU/ml, advanced FIGO stage, and microinvasion were associated with a higher recurrence rate and a shorter disease-free survival. In terms of different modalities of fertility sparing surgery, our results showed that disease-free survival did not differ significantly between ovarian cystectomy compared to salpingo-oophorectomy .