Survival analysis of borderline ovarian tumors: a 23-year retrospective study in a Middle Eastern cohort

Borderline ovarian tumors (BOTs) constitute a category of non-invasive epithelial neoplasms of the ovary, characterized by a substantially more favorable prognosis in comparison to their invasive malignant counterparts. Given their prevalence among young women, balancing oncologic safety with fertility preservation is critical for clinical management. This study evaluates factors associated with survival in patients with BOTs over a long-term follow-up period. This retrospective cohort study examined data from 135 patients diagnosed with borderline ovarian tumors (BOTs) between January 2000 and December 2023 at medical centers associated with Urmia University of Medical Sciences. Clinical and histopathological parameters were carefully extracted from both electronic and paper-based medical records. Overall survival rates were estimated using the Kaplan-Meier method, and intergroup comparisons were performed with the log-rank test. The mean patient age was 39.5 years; with most cases diagnosed at FIGO stage I (94.1%). Conservative surgical management was performed in 65.2% of patients, while 34.8% underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH + BSO). Survival rates at 1, 3, 5, and 10 years were 100%, 99.2%, 98.3%, and 97.2%, respectively. No statistically significant differences in survival were observed based on age) p = 0.442(, tumor size (P = 0.752), bilaterality (P = 0.969), Histopathology (P = 0.069), FIGO stage (P = 0.746), or surgical approach (P = 0.199). Borderline ovarian tumors (BOTs) typically manifest a benign clinical trajectory, with conservative surgical approaches demonstrating both safety and efficacy, especially in women of reproductive age. The absence of correlations between select histopathological characteristics and survival outcomes underscores the need to avoid unnecessary surgical procedures, thereby optimizing patient-centered care.