Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel.
Gynecol Oncol. 2012 May;125(2):372-5. doi: 10.1016/j.ygyno.2012.02.017. Epub 2012 Feb 21.
The classically recommended surgical treatment of borderline ovarian tumors (BOTs) includes hysterectomy in addition to bilateral adnexectomy. Possible reasons for hysterectomy might be a high frequency of uterine involvement and its favorable effect on survival. The purpose of the present study was to assess the frequency of uterine involvement in patients with BOTs and the effect of hysterectomy on survival.
All incident cases of histological confirmed BOTs diagnosed in Israeli Jewish women between March 1 1994 and June 30 1999, were identified. Clinical and pathological characteristics were abstracted from medical records. Patients with tumors grossly confined to the ovaries (apparently stage I) were considered to have had surgical staging when at least hysterectomy, bilateral salpingooophorectomy, omentectomy and pelvic lymph node sampling were done.
The study group comprised 225 patients. Hysterectomy was performed in 147 (65.31%) patients and uterine involvement was present in only 3 (2.0%) of them. The 13 year survival of the total group of patients was 85.8% and of those in apparent stage I, 88.5%. Among patients with tumors apparently confined to the ovaries, no significant survival difference was observed between unstaged and surgically staged patients. There was also no survival difference between the overall staged and unstaged patients and between patients in stages II-III who did and did not undergo hysterectomy.
Our data indicate that the rate of uterine involvement in BOT is low and that hysterectomy does not favorably affect survival. The necessity of hysterectomy in BOT patients is questioned.
经典的卵巢交界性肿瘤（BOT）的手术治疗方案包括子宫切除术加双侧附件切除术。行子宫切除术的可能原因是子宫受累的频率较高，且其对生存有积极影响。本研究旨在评估 BOT 患者子宫受累的频率以及子宫切除术对生存的影响。
本研究纳入了 1994 年 3 月 1 日至 1999 年 6 月 30 日期间在以色列犹太妇女中确诊的所有组织学证实的 BOT 病例。从病历中提取了临床和病理特征。当至少行子宫切除术、双侧附件切除术、网膜切除术和盆腔淋巴结取样术时，则认为肿瘤大体局限于卵巢（明显 I 期）的患者进行了手术分期。
本研究纳入了 225 例患者。147 例（65.31%）患者接受了子宫切除术，其中仅 3 例（2.0%）存在子宫受累。总患者组的 13 年生存率为 85.8%，明显 I 期患者的生存率为 88.5%。在肿瘤明显局限于卵巢的患者中，未分期与手术分期患者的生存无显著差异。总体分期与未分期患者之间以及行子宫切除术与未行子宫切除术的 II-III 期患者之间的生存也无差异。
我们的数据表明，BOT 中子宫受累的比例较低，且子宫切除术对生存无积极影响。因此，我们质疑 BOT 患者行子宫切除术的必要性。
