Kumpulainen Salla, Kuoppala Tapio, Leminen Arto, Komulainen Marja, Puistola Ulla, Sankila Risto, Mäkinen Juha, Grénman Seija
Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, PL 52, 20521, Finland.
Acta Obstet Gynecol Scand. 2007;86(5):610-4. doi: 10.1080/00016340701284707.
Surgical treatment and staging of ovarian borderline tumors have been reported to be often suboptimal and differ considerably. We evaluated the extent of surgical treatment of these tumors in different hospital categories.
A prospective survey performed in 1999 included 65 patients operated on for borderline ovarian tumors and covered 78% of such patients reported to the Finnish Cancer Registry. Detailed information of demographic data and surgical treatment was reported by the responsible physicians using a special questionnaire after confirmation of histopathology.
Fifty-eight patients (89%) had stage I tumor, only two patients (3%) had stage II disease and five patients (8%) had stage III disease with peritoneal implants. The majority of the patients underwent bilateral salpingo-oophorectomy (66%) and hysterectomy (58%). Unilateral salpingo-oophorectomy was performed for 21 (32%) and omentectomy for 22 (34%) patients. Ten out of the 16 women under 40 years of age had fertility-sparing surgery. Peritoneal biopsies were taken in 16 (25%) women and lymphadenectomy was performed for 9 (14%) patients with clinical suspicion of invasive ovarian carcinoma. Frozen section was taken in half of the patients and the histology remained the same in 72% of the final pathology reports. No clear differences of the extent of surgical treatment were detected between different hospital categories. Overall cumulative 5-year relative survival rate was 96%.
Bilateral salpingo-oophorectomy and hysterectomy was performed for the majority of patients with borderline ovarian tumor. More attention should be paid to adequate staging of borderline tumors in all hospital categories.
据报道，卵巢交界性肿瘤的手术治疗和分期往往不理想，且差异很大。我们评估了不同医院类别中这些肿瘤的手术治疗范围。
1999年进行的一项前瞻性调查纳入了65例接受卵巢交界性肿瘤手术的患者，涵盖了向芬兰癌症登记处报告的此类患者的78%。在组织病理学确诊后，负责的医生使用特殊问卷报告了人口统计学数据和手术治疗的详细信息。
58例患者（89%）为I期肿瘤，仅2例患者（3%）为II期疾病，5例患者（8%）为伴有腹膜种植的III期疾病。大多数患者接受了双侧输卵管卵巢切除术（66%）和子宫切除术（58%）。21例（32%）患者进行了单侧输卵管卵巢切除术，22例（34%）患者进行了大网膜切除术。16名40岁以下的女性中有10名接受了保留生育功能的手术。16名（25%）女性进行了腹膜活检，9名（14%）临床怀疑有侵袭性卵巢癌的患者进行了淋巴结切除术。一半的患者进行了冰冻切片检查，最终病理报告中有72%的组织学结果与冰冻切片一致。不同医院类别之间未发现手术治疗范围有明显差异。总体累积5年相对生存率为96%。
大多数卵巢交界性肿瘤患者接受了双侧输卵管卵巢切除术和子宫切除术。所有医院类别都应更加关注交界性肿瘤的充分分期。
