边缘卵巢肿瘤生育力保留手术的效果

D. Kurt, Ayşe Sinem Duru Çöteli, Ahmet Kurt, N. Boran
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摘要

目的:本研究旨在调查边缘性卵巢肿瘤患者接受保留生育力手术和/或根治术的结果、保留生育力手术对生育力的影响以及术后复发率:研究对象包括 138 名在安卡拉一家三级医院肿瘤诊所确诊为边缘性卵巢肿瘤的患者。患者数据通过医院信息系统进行回顾性分析。对 138 名患者的年龄、胎次、手术类型、切除淋巴结数量、复发率、治疗后怀孕率、生育率和复发率进行了分析。对接受保留生育力手术和未接受保留生育力手术的患者的复发率和生育率进行了比较:患者的年龄组分布如下:21%的患者年龄在 30 岁以下;26.1%的患者年龄在 31-40 岁之间;21%的患者年龄在 41-50 岁之间。患者的体重指数数据显示,20.3%的患者体重正常,相反,44.9%的患者体重超重(25 kg/m2 至 29.9 kg/m2)。病理结果显示,63%(87 例)为浆液性卵巢肿瘤,31.9%(44 例)为粘液性卵巢肿瘤,5.1%(7 例)为子宫内膜样边缘型卵巢肿瘤。在接受保留生育能力手术的患者中,31%(18 人)自然怀孕,5.2%(3 人)通过辅助生殖技术怀孕。研究结果显示,复发与保留生育力之间存在统计学关系。在未保留生育力的患者中,2.5%(n=2)的患者出现复发,而在保留生育力的患者中,24.1%(n=14)的患者出现复发。虽然接受保留生育力手术的患者复发率增加,但其妊娠率约为 36%:结论:由于边缘性卵巢肿瘤患者比浸润性卵巢癌患者更年轻,保留生育力手术正变得越来越重要。
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Outcomes of Fertility Sparing Surgery for Borderline Ovarian Tumors
Aim: The aim of this study was to investigate the results of fertility-preserving and/or radical surgery, the effects of fertility-preserving surgery on fertility and the postoperative recurrence rate in patients with borderline ovarian tumors. Material and Method: The study included 138 patients who were diagnosed with borderline ovarian tumors in the oncology clinic of a tertiary institution in Ankara. The patients’ data were analyzed retrospectively from the hospital information system. Among 138 patients, age, parity, type of surgery, number of lymph nodes removed, recurrence rates, pregnancy rates after treatment and fertility and recurrence analysis were performed. Recurrence and fertility rates were compared between those who underwent fertility preserving surgery and those who did not. Results: The distribution of the patıents’ age groups is as follows: 21% of the patients were under the age of 30; 26.1% were between 31-40 years of age, and 21% were between 41-50 years of age. The BMI data of the patients shows that 20.3% of the patients were in normal weight, on the contrary, 44.9% were overweight (25 kg/m2 to 29.9 kg/m2). According to the pathology results of the patients, 63% (n=87) were serous, 31.9% (n=44) mucinous, 5.1% (n=7) endometrioid type borderline ovarian tumors. Spontaneous pregnancy was observed in 31% (n=18) and pregnancy as a result of assisted reproductive techniques in 5.2% (n=3) of the patients who underwent fertility preserving surgery. According to the results of the study, it is observed that there is a statistical relationship between recurrence and fertility preservation. Recurrence was observed in 2.5% (n=2) of the individuals whose fertility was not preserved while recurrence was observed in 24.1% (n=14) of individuals whose fertility was preserved. Although it was observed that recurrence increased in patients who underwent fertility preservation surgery, it allowed pregnancy to be achieved at a rate of approximately 36%. Conclusion: Since patients with borderline ovarian tumours are younger than patients with invasive ovarian cancer, fertility-sparing surgery is becoming increasingly important.
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