Tinelli Raffaele, Tinelli Andrea, Tinelli Francesco G, Cicinelli Ettore, Malvasi Antonio
I Department of Obstetrics and Gynecology, University Medical School of Bari, Piazza Giulio Cesare, Bari, Italy.
Gynecol Oncol. 2006 Jan;100(1):185-91. doi: 10.1016/j.ygyno.2005.09.021. Epub 2005 Oct 10.
Borderline tumor of the ovary is an epithelial tumor with a low rate of growth and a low potential to invade or metastasize. This review will outline the most recent information regarding the molecular pathogenesis, pathology, fertility and tumor recurrence rate after conservative management of young women with early-stage borderline ovarian tumors.
We performed a MEDLINE literature search of relevant clinical trials for the scope of this review that evaluated conservative treatment of borderline ovarian tumors for young women with low-stage disease who wish to preserve their fertility.
Recently, investigators have begun to identify subsets of patients with a worse prognosis, such as patients with aneuploid tumors. A number of oncogenes are under investigation to determine their role in the pathogenesis of borderline ovarian tumors. Previous studies have suggested the safety of conservative surgery with unilateral salpingo-oophorectomy or cystectomy for patients with stage I borderline ovarian tumors. Laparoscopic treatment of adnexal masses has proved to be a safe and effective diagnostic and therapeutic tool in the hands of experienced laparoscopists. For women who are treated conservatively, follow-up is important. Surgery remains the most effective therapy for later stage lesions. Adjuvant therapy for advanced stage of borderline ovarian tumors remains controversial.
Conservative management of borderline ovarian tumors is an appropriate therapeutic option for young women with early-stage lesions who wish to preserve their childbearing potential. Available data indicate that in these patients fertility, pregnancy outcome and survival remain excellent.
卵巢交界性肿瘤是一种生长缓慢、侵袭或转移潜能低的上皮性肿瘤。本综述将概述有关早期卵巢交界性肿瘤年轻女性保守治疗后的分子发病机制、病理学、生育能力及肿瘤复发率的最新信息。
我们对MEDLINE文献进行检索，以查找本综述范围内评估希望保留生育能力的低分期疾病年轻女性卵巢交界性肿瘤保守治疗的相关临床试验。
最近，研究人员已开始识别预后较差的患者亚组，如非整倍体肿瘤患者。许多癌基因正在接受研究，以确定它们在卵巢交界性肿瘤发病机制中的作用。既往研究提示，对于Ⅰ期卵巢交界性肿瘤患者，行单侧输卵管卵巢切除术或囊肿切除术的保守手术是安全的。在经验丰富的腹腔镜手术医生手中，腹腔镜治疗附件肿块已被证明是一种安全有效的诊断和治疗工具。对于接受保守治疗的女性，随访很重要。手术仍然是晚期病变最有效的治疗方法。卵巢交界性肿瘤晚期的辅助治疗仍存在争议。
对于希望保留生育潜能的早期病变年轻女性，卵巢交界性肿瘤的保守治疗是一种合适的治疗选择。现有数据表明，这些患者的生育能力、妊娠结局及生存率仍然良好。
