Do you routinely recommend completion hysterectomy with contralateral salpingo-oophorectomy for patients with a history of fertility-sparing staging for borderline tumor of the ovary who have since completed childbearing?

Borderline ovarian tumors, also known as atypical proliferative tumors by WHO classification, account for about 10-20% of epithelial ovarian tumors, have histologic subtypes similar to invasive ovarian cancer, and are characterized pathologically by a high degree of proliferation of the epithelial cells with some degree of nuclear atypia in the absence of invasion into the stroma. They are considered an intermediate category of tumors between benign and malignant but remain somewhat controversia...

I agree that I do not routinely recommend completion surgery in a patient who previously had a borderline tumor and underwent fertility-sparing surgery. If a patient in this scenario has a future recurrence of borderline tumor and has since completed childbearing, then I would discuss and offer completion surgery. However, it is important to discuss both the risks of premature surgical menopause as well as the low risk of progression to carcinoma of 2-3% (usually low grade serous carcinoma).