Effects of Fertility-Sparing Surgery on Prognosis and Fertility of Patients With Ovarian Borderline Tumors.

Q4 Medicine 中国医学科学院学报 Pub Date : 2024-12-01 DOI:10.3881/j.issn.1000-503X.16054

Xiao-Xiao Lin, Lin Tang, Ming-Jie Yang, Bai-Lei Zhang

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Abstract

Objective To compare the safety and efficacy of fertility-sparing surgery in patients with ovarian borderline tumors (BOT). Methods A total of 121 BOT patients undergoing fertility-sparing surgery between January 2010 and October 2022 were retrospectively analyzed.The univariate analysis,multivariate analysis,and survival curves were employed to evaluate the clinicopathological and surgical variables and fertility. Results The 121 BOT patients included in this study showed the 5-year recurrence-free survival (RFS) rate of 65.8% and the recurrence rate of 30.5%.A total of 53 patients attempted to conceive and 40 (33.06%) of the patients achieved successful pregnancy.Different methods of fertility-sparing surgery did not affect the tumor recurrence rate,RFS,or pregnancy rate.The multivariate analysis indicated that the International Federation of Gynecology and Obstetrics (FIGO) stage ≥Ⅱ was an independent risk factor affecting both postoperative recurrence and RFS (P=0.011,OR=6.504,95%CI=1.534-27.58;P=0.033,HR=2.589,95%CI=1.082-6.194) in BOT patients.Tissue type (mucinous) was negatively correlated with the risk of recurrence after fertility-sparing surgery (P=0.011,OR=0.270,95%CI=0.099-0.739).The two unilateral surgical methods showed differences in the amount of intraoperative bleeding (P=0.010),postoperative hospital stay (P=0.001),duration of antibiotic use (P=0.002),and tumor rupture rate (P=0.030),which were not significantly different between the two bilateral surgical methods. Conclusions For young patients with fertility requirements,fertility-sparing surgery is safe and effective.After a comprehensive assessment of clinicopathological factors,unilateral cystectomy and bilateral cystectomy may be recommended as the preferred choice of treatment.For the patients with advanced FIGO stages who strongly prefer fertility sparing,fertility-sparing surgery can be performed with fully informed consent,and these patients should attempt to achieve pregnancy as soon as possible after the surgery.

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保留生育能力手术对卵巢交界性肿瘤患者预后及生育能力的影响。

目的比较保生育手术治疗卵巢交界性肿瘤（BOT）的安全性和有效性。方法回顾性分析2010年1月至2022年10月行保生育手术的121例BOT患者。采用单因素分析、多因素分析和生存曲线评价临床病理和手术变量及生育能力。结果121例BOT患者5年无复发生存率（RFS）为65.8%，复发率为30.5%。53例患者尝试妊娠，40例（33.06%）患者成功妊娠。不同的保生育手术方法对肿瘤复发率、RFS和妊娠率没有影响。多因素分析显示，国际妇产科联合会（FIGO）分期≥Ⅱ是影响BOT患者术后复发和RFS的独立危险因素（P=0.011，OR=6.504,95%CI=1.534-27.58；P=0.033，HR=2.589,95%CI=1.082-6.194）。组织类型（粘液）与保留生育手术后复发风险呈负相关（P=0.011，OR=0.270,95%CI=0.099 ~ 0.739）。两种单侧手术方式术中出血量（P=0.010）、术后住院时间（P=0.001）、抗生素使用时间（P=0.002）、肿瘤破裂率（P=0.030）差异无统计学意义，两种双侧手术方式间差异无统计学意义。结论对于有生育需求的年轻患者，保生育手术是安全有效的。在综合评估临床病理因素后，可能推荐单侧膀胱切除术和双侧膀胱切除术作为首选治疗方法。对于FIGO晚期患者，强烈希望保留生育能力，可以在充分知情同意的情况下进行保留生育手术，这些患者应在手术后尽快实现妊娠。

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来源期刊

中国医学科学院学报 Medicine-Medicine (all)

CiteScore

0.60

自引率

0.00%

发文量

6813

期刊介绍： Acta Academiae Medicinae Sinicae was founded in February 1979. It is a comprehensive medical academic journal published in China and abroad, supervised by the Ministry of Health of the People's Republic of China and sponsored by the Chinese Academy of Medical Sciences and Peking Union Medical College. The journal mainly reports the latest research results, work progress and dynamics in the fields of basic medicine, clinical medicine, pharmacy, preventive medicine, biomedicine, medical teaching and research, aiming to promote the exchange of medical information and improve the academic level of medicine. At present, the journal has been included in 10 famous foreign retrieval systems and their databases [Medline (PubMed online version), Elsevier, EMBASE, CA, WPRIM, ExtraMED, IC, JST, UPD and EBSCO-ASP]; and has been included in important domestic retrieval systems and databases [China Science Citation Database (Documentation and Information Center of the Chinese Academy of Sciences), China Core Journals Overview (Peking University Library), China Science and Technology Paper Statistical Source Database (China Science and Technology Core Journals) (China Institute of Scientific and Technological Information), China Science and Technology Journal Paper and Citation Database (China Institute of Scientific and Technological Information)].