When considering laparoscopic surgery for ovarian cysts (OCs), physicians must preoperatively differentiate benign ovarian tumours (Be-OTs) from other tumours, primarily based on magnetic resonance imaging (MRI) findings. Ovarian endometriotic cysts (OECs) and ovarian mature cystic teratomas (OMCTs) can typically be identified with high accuracy using MRI. However, OCs other than OECs and OMCTs may show borderline/malignant OT (Bo/Ma-OT) features on postoperative pathology, even when no suspicious solid components are detected preoperatively. Therefore, the aim of this study was to retrospectively analyse the data of 239 patients over a 15-year period at our institution to explore the potential for preoperative prediction of Bo/Ma-OT.

From July 1, 2010 and December 31, 2024, 239 patients who underwent laparoscopic surgery for preoperatively diagnosed serous/mucinous OCs (Se/Mu-OCs) were retrospectively analysed. Among them, 26 cases, including 23 borderline and 3 malignant tumours identified on postoperative pathological examination, were the primary focus of this study. To evaluate the influence of 16 factors, including MRI findings, tumour markers, and basic patient characteristics, both univariate and multivariate analyses were performed.

According to the results of the chi-square test and multivariate analysis, none of the factors was significantly associated with an increased likelihood of Bo/Ma-OT.

Preoperative prediction of Bo/Ma-OT in patients undergoing laparoscopic surgery for Se/Mu-OCs remains challenging. Further accumulation of cases and continued analysis will be necessary.