Academic Division of Gynecologic Oncology, Mauriziano Hospital, Turin, Italy.
Int J Gynecol Cancer. 2012 Sep;22(7):1158-62. doi: 10.1097/IGC.0b013e31825e5254.
The aims of this study were to evaluate the rate of recurrences in borderline ovarian tumors (BOTs) with microinvasion and to evaluate the possibility to enlarge fertility-sparing surgery in this group of patients.
Between 1985 and 2010, 209 patients with BOTs were retrospectively divided into 2 groups: group 1 consisted of 28 women with microinvasive BOTs; group 2 consisted of 181 with BOTs without microinvasion. All of the patients were submitted to surgical treatment: in group 1, 10 patients underwent cystectomy (CYS), 11 patients underwent monolateral salpingo-oophorectomy (MSO), and 7 patients underwent bilateral oophorectomy with or without total hysterectomy (BSO); in group 2, 34 patients underwent CYS, 58 patients underwent MSO, and 89 patients underwent BSO. Specific prognostic factors such as stage, surgical approach, intraoperative spillage, histology, exophytic tumor growth, and endosalpingiosis were analyzed. Tumor recurrence rate and overall and disease-free survivals were evaluated.
After a mean follow-up of 53 months, relapses occurred in 21.4% of the cases in group 1 and in 12.7% of the cases in group 2 (P = 0.21). The prognostic factors had no significant differences in the 2 groups. Relapses after CYS, MSO, and BSO were observed in 30%, 27.3%, and 0%, respectively, in group 1 and in 29.4%, 12.1%, and 6.7%, respectively, in group 2. Progression-free survival was significantly longer in BOTs compared to microinvasive BOTs (P = 0.041), but overall survival did not differ.
Although exploratory, our data suggest that BOTs with microinvasion present earlier relapses, but overall incidence of relapses and overall survival do not differ significantly from BOTs without microinvasion. Fertility-sparing surgery is feasible in this group of patients, but strict follow-up has to be suggested.
本研究旨在评估具有微浸润的交界性卵巢肿瘤（BOT）的复发率，并评估在这组患者中扩大保留生育力手术的可能性。
1985 年至 2010 年，回顾性地将 209 例 BOT 患者分为 2 组：组 1 包括 28 例微浸润性 BOT 患者；组 2 包括 181 例无微浸润性 BOT 患者。所有患者均接受手术治疗：组 1 中，10 例患者行囊肿切除术（CYS），11 例患者行单侧输卵管卵巢切除术（MSO），7 例患者行双侧卵巢切除术伴或不伴全子宫切除术（BSO）；组 2 中，34 例患者行 CYS，58 例患者行 MSO，89 例患者行 BSO。分析了特定的预后因素，如分期、手术方式、术中溢出、组织学、外生性肿瘤生长和内膜异位症。评估了肿瘤复发率、总生存率和无病生存率。
平均随访 53 个月后，组 1 中 21.4%的病例复发，组 2 中 12.7%的病例复发（P = 0.21）。两组患者的预后因素无显著差异。组 1 中 CYS、MSO 和 BSO 后复发分别为 30%、27.3%和 0%，组 2 中分别为 29.4%、12.1%和 6.7%。BOT 的无进展生存率明显长于微浸润性 BOT（P = 0.041），但总生存率无差异。
尽管是探索性的，但我们的数据表明，具有微浸润的 BOT 复发较早，但总体复发率和总生存率与无微浸润的 BOT 无显著差异。在这组患者中可行保留生育力手术，但必须建议严格随访。
