Improving the clinical management of women with borderline tumours: a recurrence risk scoring system from a French multicentre study

To develop a risk scoring system (RSS) for predicting recurrence in women with borderline ovarian tumours (BOTs).Cohort study of women with BOTs.French multicentre tertiary care centres.A cohort of 360 women with BOTs who received primary surgical treatment between January 2000 and December 2013.Clinical and pathological factors affecting recurrence in women with BOTs.The development of a model for the prediction of recurrence in women with BOTs.Overall the recurrence rate was 20.0% (72/360). Recurrence was associated with five variables: age 45 years; preoperative serum tumour marker CA125 150 IU/mL; a serous histological subtype; International Federation of Gynecology and Obstetrics (FIGO) stage other than IA; and ovarian surgery other than bilateral salpingo-oophorectomy (BSO; i.e. cystectomy and unilateral salpingo-oophorectomy). These variables were included in the RSS and assigned scores ranging from 0 to 6. The discrimination of the RSS was 0.82 (95% confidence interval, 95% CI 0.79-0.85). A total score of 8 points corresponded to the optimal threshold of the RSS, with a rate of recurrence of 11.8% (35/297) and 58.7% (37/63) for women at low risk (8 points) and women at high risk (≥8 points), respectively. The diagnostic accuracy was 85.0%.This study shows that the risk of BOT recurrence can be accurately predicted so that women at high risk can benefit from adapted surgical treatment.Our RSS permitted women with BOTs at low risk to be distinguished from women with BOTs at high risk of recurrence.