Survival Analysis of Borderline Ovarian Tumors: A 23-Year Retrospective Study in a Middle Eastern Cohort

Background Borderline ovarian tumors (BOTs) are non-invasive epithelial lesions with a generally favorable prognosis compared to invasive ovarian cancers. 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. Materials and Methods This retrospective analysis reviewed data from 135 patients diagnosed with BOTs between 2000 and 2023 at healthcarefı facilities affiliated with Urmia University of Medical Sciences. Clinical and pathological data were extracted from patient records. Survival was estimated using the Kaplan–Meier method, and group comparisons were conducted with the Log-rank test. Results The mean patient age was 39.5 years; with most cases diagnosed at FIGO stage I. 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, tumor size, bilaterality, FIGO stage, or surgical approach. Conclusion BOTs generally exhibit a favorable clinical course, and conservative surgery appears safe and effective, particularly for younger women. The lack of association between certain pathological features and survival suggests that unnecessary surgical interventions should be avoided. Further prospective, multicenter studies are needed to validate these findings in diverse populations.