Current status of fertility preservation for borderline ovarian tumor in Asian regions: results from ASGO-special task force for fertility preservation; part I. Fertility-sparing treatment for borderline ovarian tumor.

OBJECTIVE: Epithelial borderline ovarian tumors (BOTs) commonly affect women of reproductive age, making fertility preservation (FP) an important clinical consideration. This study aimed to evaluate the current status of FP practices for BOT across Asian regions and to identify variations and areas requiring standardization.

METHODS: A cross-sectional survey was conducted by the Asian Society of Gynecologic Oncology special task force. Ten regions (Japan, South Korea, Chinese Mainland, Taiwan, Hong Kong, Thailand, Indonesia, India, Malaysia, and the Philippines) participated. A 10-item questionnaire addressed indications, surgical approaches, and management strategies for FP in BOT (part I).

RESULTS: Seven of the 10 regions (70%) reported an upper age limit for fertility-sparing surgery (FSS), ranging from 35 years to menopause. Indications based on histologic subtype varied across regions. FSS for stage II or higher disease was considered in 7 regions (70%). Laparoscopic surgery was performed in 3 regions (30%), all in East Asia. Lymphadenectomy was performed in 3 regions (30%). Strategies for additional surgery following incomplete initial procedures varied, reflecting differences in prioritization between ovarian preservation and oncologic radicality.

CONCLUSION: Substantial regional variation exists in FP practices for BOT across Asia. Although a general trend toward fertility-sparing strategies is evident, standardization based on high-quality evidence is needed. Future research should focus on optimizing oncologic safety while preserving fertility and supporting shared decision-making in this patient population.