Risk factors analysis
In univariate analysis, increase of age, large palpable mass, bilateral
synchronous forms at diagnosis and perioperative rupture had a
statistical impact on the risk of second tumor events (Table 1, Fig. 1B
and C). In the multivariate analysis, the same variables except age
remained prognostic (Table 1). Neither the type of surgical approach
(laparoscopy and laparotomy) nor the type of tumor resection (TO and
OSS) influenced the risk of recurrence (Table 1). In the subgroup that
benefited from OSS, the second event was not influenced by the initial
surgical approach. Perioperative rupture was considered a risk factor
for a second event, with a 2-year EFS of 85.0% [95% CI, 60.4 –
94.9] vs. 96.0% [95% CI, 92.3 – 98.0] (Fig. 1B). Twenty-four
percent of patients with second events experienced a perioperative tumor
rupture during an OSS procedure (Table 3). The second event was,
however, on the contralateral ovary in all cases except two, where
recurrence was bilateral or with JCGT in the ipsilateral ovary.
Perioperative rupture during OSS was thus not associated with a second
event in the ipsilateral ovary (p=0.41).