OBJECTIVE To assess the efficacy of fertility-sparing surgery (FSS) in terms of reproductive outcomes by following FSS for borderline ovarian tumors (BOTs) and comparing the safety of FSS versus radical surgery (RS). DESIGN Nationwide cohort study based on prospectively recorded data. SETTING Sweden. PATIENT (S) All women of reproductive age (18-40 years) treated in Sweden for stage I BOT with the use of FSS or RS from 2008 to 2015, identified in the Swedish Quality Registry for Gynecologic Cancer (SQRGC). INTERVENTIONS (S) FSS or RS. MAIN OUTCOME MEASURE (S) Reproductive outcomes: natural conception, use of assisted reproductive technology (ART), live birth and obstetrical outcomes. Safety outcome: overall survival (OS) rates, comparing women undergoing FSS versus RS. The FSS cohort was linked to the Swedish Medical Birth Register to identify all women who had given birth after FSS and to obtain detailed obstetrical data. For information on ART treatment, the National Quality Registry for Assisted Reproduction was consulted. OS rate comparisons were conducted by means of Kaplan-Meier estimates. RESULT (S) Of the 277 women with BOTs, 213 (77%) underwent FSS, 183 (86%) unilateral salpingo-oophorectomy, and 30 (14%) cystectomy. Following FSS, 50 women gave birth to 62 healthy children, 8% of which were preterm. Only 20 (9%) of the women underwent ART treatment. OS was similar in women treated with FSS and RS. CONCLUSION (S) Natural fertility was maintained after FSS; only 9% required ART treatment. FSS was also deemed to be equivalent to RS regarding survival outcome.

中文翻译：

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生殖和产科结果与瑞典交界性卵巢肿瘤保生育手术治疗的育龄妇女的总生存率：一项前瞻性全国人口研究

目的 通过遵循 FSS 治疗交界性卵巢肿瘤 (BOTs) 并比较 FSS 与根治性手术 (RS) 的安全性，评估保留生育手术 (FSS) 在生殖结果方面的疗效。设计 基于前瞻性记录数据的全国性队列研究。设置瑞典。患者 (S) 2008 年至 2015 年在瑞典使用 FSS 或 RS 进行 I 期 BOT 治疗的所有育龄妇女（18-40 岁），在瑞典妇科癌症质量登记处 (SQRGC) 中确定。干预 (S) FSS 或 RS。主要结果测量 (S) 生殖结果：自然受孕、辅助生殖技术 (ART) 的使用、活产和产科结果。安全性结果：总生存率 (OS)，比较接受 FSS 与 RS 的女性。FSS 队列与瑞典医疗出生登记册相关联，以识别所有在 FSS 后分娩的妇女并获得详细的产科数据。有关 ART 治疗的信息，请咨询国家辅助生殖质量登记处。OS 率比较是通过 Kaplan-Meier 估计进行的。结果 (S) 在 277 名 BOT 女性中，213 名 (77%) 接受了 FSS，183 名 (86%) 单侧输卵管卵巢切除术和 30 名 (14%) 膀胱切除术。在 FSS 之后，50 名妇女生下了 62 名健康儿童，其中 8% 是早产儿。只有 20 (9%) 名女性接受了 ART 治疗。接受 FSS 和 RS 治疗的女性的 OS 相似。结论（S）FSS后自然生育力得以维持；只有 9% 需要 ART 治疗。在生存结果方面，FSS 也被认为与 RS 相同。