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单侧输卵管卵巢切除术作为交界性卵巢肿瘤的保留生育功能手术。

Unilateral salpingo-oophorectomy as fertility-sparing surgery for borderline ovarian tumors.

机构信息

Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2011 Jun;74(6):250-4. doi: 10.1016/j.jcma.2011.04.003. Epub 2011 May 12.

Abstract

BACKGROUND

To investigate recurrence rates and fertility outcomes of patients with borderline ovarian tumors (BOTs) treated with fertility-sparing surgery.

METHODS

This was a retrospective study. All women with BOTs from 2000 to 2006 were evaluated. Clinical outcomes were compared among groups that underwent radical, unilateral salpingo-oophorectomy, or ovarian cystectomy. The effects of clinical characteristics on recurrence were analyzed by independent t test, chi-square test, and Cox proportional hazard model.

RESULTS

After a mean follow-up period of 56.5 months, all 61 patients were alive. Seven (11.5%) had developed disease recurrence, and all were in the fertility-sparing group. Of these, five were in the cystectomy-only group and two in the unilateral salpingo-oophorectomy group. There was significant difference in tumor recurrence rates between the two groups (hazard ratio: 0.26, 95% confidence interval: 0.11-0.61). Nine pregnancies were achieved in six women, resulting in five deliveries

CONCLUSION

Fertility-sparing surgery is an acceptable and safe option for women with BOTs who wish to preserve fertility. Unilateral salpingo-oophorectomy must be considered as the first choice.

摘要

背景

研究旨在探讨行保留生育功能手术的交界性卵巢肿瘤(BOT)患者的复发率和生育结局。

方法

这是一项回顾性研究。对 2000 年至 2006 年所有的 BOT 患者进行评估。对行根治性手术、单侧附件切除术或卵巢囊肿切除术的患者进行分组,比较各组的临床结局。采用独立 t 检验、卡方检验和 Cox 比例风险模型分析临床特征对复发的影响。

结果

在平均随访 56.5 个月后,所有 61 例患者均存活。7 例(11.5%)出现疾病复发,均在保留生育功能组。其中,5 例仅行囊肿切除术,2 例仅行单侧附件切除术。两组肿瘤复发率存在显著差异(风险比:0.26,95%置信区间:0.11-0.61)。6 名妇女中有 9 例妊娠,5 例分娩。

结论

对于希望保留生育功能的 BOT 患者,保留生育功能手术是一种可接受且安全的选择。单侧附件切除术必须作为首选。

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