Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Int J Gynecol Cancer. 2011 May;21(4):640-6. doi: 10.1097/IGC.0b013e3182129842.
To evaluate the oncological safety and reproductive outcomes of patients with borderline ovarian tumors (BOTs) treated with fertility-sparing surgery.
Patients with BOTs who underwent radical or fertility-sparing surgery between 1997 and 2009 were identified from an institutional database. The recurrence rates were compared between the 2 surgery groups. To compare the reproductive outcomes, all patients who underwent fertility-sparing surgery were interviewed by telephone.
One hundred forty-three patients underwent radical surgery, and 155 patients underwent fertility-sparing surgery. After a median interval of 38 months from the initial surgery (range, 10-77 months), 19 patients had a recurrence. The recurrence rate was similar in the radical and fertility-sparing surgery groups (4.9% and 7.7%, respectively; P = 0.280). In the fertility-sparing surgery group, however, the main site of recurrence was the remaining ovary that was successfully salvaged with a second round of fertility-sparing surgery. Of 51 patients who attempted to conceive, 45 patients (88.2%) were successful and resulted in 54 term deliveries.
Fertility-sparing surgery for BOTs is safe and can result in future pregnancies, suggesting that such surgery should be considered for young patients who desire preservation of fertility.
评估接受保留生育功能手术的交界性卵巢肿瘤(BOT)患者的肿瘤安全性和生殖结局。
从机构数据库中确定了 1997 年至 2009 年间接受根治性或保留生育功能手术的 BOT 患者。比较了两组手术的复发率。为了比较生殖结局,所有接受保留生育功能手术的患者均通过电话进行了访谈。
143 例患者接受根治性手术,155 例患者接受保留生育功能手术。初次手术后中位数间隔 38 个月(范围,10-77 个月)后,19 例患者复发。根治性手术和保留生育功能手术组的复发率相似(分别为 4.9%和 7.7%;P = 0.280)。然而,在保留生育功能手术组中,复发的主要部位是成功保留的剩余卵巢,并用第二轮保留生育功能手术进行了挽救。在 51 例尝试怀孕的患者中,45 例(88.2%)成功,导致 54 例足月分娩。
BOT 的保留生育功能手术是安全的,并可以导致未来的妊娠,这表明对于希望保留生育能力的年轻患者,应考虑进行此类手术。