Division of Gynecology, European Institute of Oncology, Milan, Italy.
Gynecol Oncol. 2010 Nov;119(2):274-7. doi: 10.1016/j.ygyno.2010.07.034. Epub 2010 Aug 24.
Borderline ovarian tumors (BOTs) are a histological category of epithelial ovarian tumors and 70% of them are early diagnosed (stage I). Since early stage is the most important prognostic factor, restaging procedure could be justified. This study aims to evaluate the role of restaging surgery in the management of patients with borderline ovarian tumors referred to our Institution after being incompletely surgically staged in other hospitals.
We retrospectively reviewed the charts of patients with BOT who were referred to our centre to undergo restaging procedure. From December 1995 to May 2008, 186 patients were treated for BOT and 70 patients met the inclusion criteria. Data collected included patients' age, primary and re-staging surgery details, FIGO stage after first and second procedure, pathological findings, and follow-up data.
FIGO stage after primary surgery was IA in 46 patients (68.6%), IB in 7 patients (10.4%), IC in 12 patients (17.9%, 6 due to ruptured cyst), IIA in 1 patient (1.4%), IIB in 1 patient (1.4%), III B in 2 patients (2.8%), and IIIC in 1 patient (1.4%). Among stage I patients (representing 97% of all patients), 12.3% (8 patients) were up-staged. The upstaging rate among serous tumors was 16.2%, and 4% among mucinous tumors. The mean follow-up time was 60.4 months from restaging surgery (SD 30.6 months). We observed 8 primary recurrences of the disease and 3 second recurrences.
There were no differences in terms of overall survival between patients who were upstaged and those who were not. Restaging procedure does not seem to have a significant impact on the management of patients diagnosed with borderline ovarian tumors, especially in mucinous subtype and apparent FIGO stage higher than I.
交界性卵巢肿瘤（BOT）是一种上皮性卵巢肿瘤的组织学类别，其中 70%为早期诊断（I 期）。由于早期是最重要的预后因素，因此可以进行重新分期手术。本研究旨在评估在其他医院不完全手术分期后转至我院的交界性卵巢肿瘤患者进行重新分期手术的作用。
我们回顾性分析了转至我院进行重新分期手术的 BOT 患者的病历。1995 年 12 月至 2008 年 5 月，共治疗了 186 例 BOT 患者，其中 70 例符合纳入标准。收集的数据包括患者年龄、首次和再次手术的详细信息、首次和再次手术后的 FIGO 分期、病理发现和随访数据。
首次手术后的 FIGO 分期为 IA 期 46 例（68.6%），IB 期 7 例（10.4%），IC 期 12 例（17.9%，6 例因囊肿破裂），IIA 期 1 例（1.4%），IIB 期 1 例（1.4%），IIIB 期 2 例（2.8%），IIIC 期 1 例（1.4%）。在所有患者中，IA 期患者（占 97%）中有 12.3%（8 例）被升级。浆液性肿瘤的升级率为 16.2%，粘液性肿瘤为 4%。从重新分期手术到随访结束的平均时间为 60.4 个月（标准差 30.6 个月）。我们观察到 8 例疾病的原发性复发和 3 例继发性复发。
在总生存率方面，升级组和未升级组之间没有差异。重新分期手术似乎对诊断为交界性卵巢肿瘤的患者的管理没有显著影响，特别是在粘液性肿瘤亚型和明显的 FIGO 分期高于 I 期的情况下。
