Borderline ovarian tumours in a middle-income country setting: a ten-year retrospective review of cases in a tertiary hospital in South Africa

dc.contributor.advisorRogers, Linda
dc.contributor.advisorAdams, Tracey
dc.contributor.authorGhunney, Ama
dc.date.accessioned2025-09-05T12:37:31Z
dc.date.available2025-09-05T12:37:31Z
dc.date.issued2025
dc.date.updated2025-09-05T06:16:16Z
dc.description.abstractThe diagnosis and management of borderline ovarian tumours remain controversial almost a century after their initial description, and little research has been done in Africa to provide answers on the prevalence and outcomes of these tumours. This study is a review of cases of borderline ovarian tumours seen in Groote Schuur Hospital over a ten-year period. Objective: To describe the demographic characteristics, occurrence, treatment, and outcomes of women diagnosed with borderline ovarian tumour at Groote Schuur Hospital, a tertiary hospital in South Africa. Methods: A retrospective review of women diagnosed with borderline ovarian tumour in Groote Schuur Hospital between January 2005 and December 2014 was undertaken by reviewing our gynaecological oncology database and patients' folders. Women with multiple primary tumours, lost to follow-up, or with inadequate clinical data were excluded. Demographic characteristics, preoperative, operative, postoperative, oncologic, and pathologic data was retrieved and analyzed. Results: Ninety-one patients were diagnosed with borderline ovarian tumour in the study period. Nineteen were eliminated and 72 analysed. Borderline ovarian tumours accounted for 22.3% of 409 ovarian neoplasms registered with our gynaecological oncology database in the study period. The median age was 48.5 years, (range, 16–82 years) with 31.9% (n=23) of women less than 40 years of age. Seventy-point eight percent (n=51) of patients were completely surgically staged and 80.6% (n=58) were optimally debulked. Thirty-one-point nine percent (n=23) underwent fertility-sparing surgery and of these 17.4% (n=4) had completion surgery. Mucinous histology was the most common histological subtype (57%). The median time to recurrence was 42.9 months (range 1.0 to 108.0 months). Serous histology and fertility-sparing surgery were independently associated with recurrence (p=0.016, p=0.026 respectively). Our overall recurrence rate was 13.9% (n=10) with 40% of these being invasive (n=4). The 5-year overall survival rate was 91.7% and the 5-year relapse- free survival rate was 89.9%. Despite small numbers, all patients with invasive recurrence died within 5 years of recurrence, whiles all patients who recurred with borderline histology were alive 5 years after recurrence. Conclusion: Mucinous histology was the most common histological subtype (57%). Regardless of a generally favourable prognosis, patients who recurred as invasive disease were all dead 5 years after recurrence, whiles patients who recurred with borderline histology were all alive 5 years after recurrence.
dc.identifier.apacitationGhunney, A. (2025). <i>Borderline ovarian tumours in a middle-income country setting: a ten-year retrospective review of cases in a tertiary hospital in South Africa</i>. (). Universiy of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology. Retrieved from http://hdl.handle.net/11427/41706en_ZA
dc.identifier.chicagocitationGhunney, Ama. <i>"Borderline ovarian tumours in a middle-income country setting: a ten-year retrospective review of cases in a tertiary hospital in South Africa."</i> ., Universiy of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2025. http://hdl.handle.net/11427/41706en_ZA
dc.identifier.citationGhunney, A. 2025. Borderline ovarian tumours in a middle-income country setting: a ten-year retrospective review of cases in a tertiary hospital in South Africa. . Universiy of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology. http://hdl.handle.net/11427/41706en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Ghunney, Ama AB - The diagnosis and management of borderline ovarian tumours remain controversial almost a century after their initial description, and little research has been done in Africa to provide answers on the prevalence and outcomes of these tumours. This study is a review of cases of borderline ovarian tumours seen in Groote Schuur Hospital over a ten-year period. Objective: To describe the demographic characteristics, occurrence, treatment, and outcomes of women diagnosed with borderline ovarian tumour at Groote Schuur Hospital, a tertiary hospital in South Africa. Methods: A retrospective review of women diagnosed with borderline ovarian tumour in Groote Schuur Hospital between January 2005 and December 2014 was undertaken by reviewing our gynaecological oncology database and patients' folders. Women with multiple primary tumours, lost to follow-up, or with inadequate clinical data were excluded. Demographic characteristics, preoperative, operative, postoperative, oncologic, and pathologic data was retrieved and analyzed. Results: Ninety-one patients were diagnosed with borderline ovarian tumour in the study period. Nineteen were eliminated and 72 analysed. Borderline ovarian tumours accounted for 22.3% of 409 ovarian neoplasms registered with our gynaecological oncology database in the study period. The median age was 48.5 years, (range, 16–82 years) with 31.9% (n=23) of women less than 40 years of age. Seventy-point eight percent (n=51) of patients were completely surgically staged and 80.6% (n=58) were optimally debulked. Thirty-one-point nine percent (n=23) underwent fertility-sparing surgery and of these 17.4% (n=4) had completion surgery. Mucinous histology was the most common histological subtype (57%). The median time to recurrence was 42.9 months (range 1.0 to 108.0 months). Serous histology and fertility-sparing surgery were independently associated with recurrence (p=0.016, p=0.026 respectively). Our overall recurrence rate was 13.9% (n=10) with 40% of these being invasive (n=4). The 5-year overall survival rate was 91.7% and the 5-year relapse- free survival rate was 89.9%. Despite small numbers, all patients with invasive recurrence died within 5 years of recurrence, whiles all patients who recurred with borderline histology were alive 5 years after recurrence. Conclusion: Mucinous histology was the most common histological subtype (57%). Regardless of a generally favourable prognosis, patients who recurred as invasive disease were all dead 5 years after recurrence, whiles patients who recurred with borderline histology were all alive 5 years after recurrence. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Middle Income LK - https://open.uct.ac.za PB - Universiy of Cape Town PY - 2025 T1 - Borderline ovarian tumours in a middle-income country setting: a ten-year retrospective review of cases in a tertiary hospital in South Africa TI - Borderline ovarian tumours in a middle-income country setting: a ten-year retrospective review of cases in a tertiary hospital in South Africa UR - http://hdl.handle.net/11427/41706 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41706
dc.identifier.vancouvercitationGhunney A. Borderline ovarian tumours in a middle-income country setting: a ten-year retrospective review of cases in a tertiary hospital in South Africa. []. Universiy of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41706en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Obstetrics and Gynaecology
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversiy of Cape Town
dc.subjectMiddle Income
dc.titleBorderline ovarian tumours in a middle-income country setting: a ten-year retrospective review of cases in a tertiary hospital in South Africa
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMasters
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