Poncelet Christophe, Fauvet Raffaèle, Boccara Joëlle, Daraï Emile
Service de Gynécologie-Obstétrique, Hôpital Tenon, AP-HP, 4 Rue de la Chine, CancerEst, UFR Saint-Antoine, Paris VI, 75020, France.
Ann Surg Oncol. 2006 Apr;13(4):565-71. doi: 10.1245/ASO.2006.12.024. Epub 2006 Feb 24.
Fertility-sparing surgery for borderline ovarian tumors (BOT) is feasible and effective and does not seem to have a negative effect on survival. Specific data on the effect of cystectomy, and notably on recurrence, are lacking.
This was a French retrospective multicenter study of 313 women with stage I BOT treated from 1990 to 2000 in 13 specialized gynecological units and 1 cancer center. Diagnosis and staging were based on International Federation of Gynecology and Obstetrics (1989) criteria. Surgery consisted of cystectomy, unilateral salpingo-oophorectomy (USO), or bilateral salpingo-oophorectomy (BSO).
After cystectomy, persistent BOT and benign ovarian cysts on the operated ovary were observed in 15% and 65% of patients, respectively. Mean follow-up did not differ among patients receiving the three types of surgery. The recurrences after cystectomy, USO, and BSO treatment were 30.3%, 11%, and 1.7%, respectively (P<.0001). Recurrences were more frequent after cystectomy than after USO (P=.0001) and BSO (P=.0001) and when intraoperative cyst rupture occurred (P=.04).
These results suggest that cystectomy for BOT is associated with a high risk of intraoperative cyst rupture and of recurrence compared with USO or BSO.
对于交界性卵巢肿瘤(BOT),保留生育功能的手术是可行且有效的,似乎对生存没有负面影响。关于囊肿切除术的效果,尤其是对复发的影响,缺乏具体数据。
这是一项法国的回顾性多中心研究,研究对象为1990年至2000年在13个专业妇科单位和1个癌症中心接受治疗的313例Ⅰ期BOT女性患者。诊断和分期基于国际妇产科联盟(1989年)标准。手术包括囊肿切除术、单侧输卵管卵巢切除术(USO)或双侧输卵管卵巢切除术(BSO)。
囊肿切除术后,分别有15%和65%的患者在手术侧卵巢出现持续性BOT和良性卵巢囊肿。接受三种手术类型的患者的平均随访时间无差异。囊肿切除术、USO和BSO治疗后的复发率分别为30.3%、11%和1.7%(P<0.0001)。囊肿切除术后的复发比USO(P=0.0001)和BSO(P=0.0001)后更频繁,并且在术中囊肿破裂时复发更频繁(P=0.04)。
这些结果表明,与USO或BSO相比,BOT的囊肿切除术与术中囊肿破裂和复发的高风险相关。