Chen Ruifang, Zhu Tingting, Yu Hailin, Zhu Jing, Lu Xin
Department of Gynecologic Oncology, the Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
Department of Gynecologic Oncology, the Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China. Email:
Zhonghua Fu Chan Ke Za Zhi. 2014 Apr;49(4):254-9.
To analyse the clinical practicability and significance of fertility-sparing surgery for women with recurrent borderline ovarian tumors (BOT).
The clinical and pathological recordings of 12 patients suffered from recurrent BOT in the Obstetrics and Gynecology Hospital of Fudan University from Jan.2002 to Dec. 2012 were analyzed retrospectively. The menstruation situation, fertility function, recurrence rate and survival after second conservative surgery were collected and analyzed.
The average onset age of these 12 patients was 26 years, and none of them had procreation before the second operation. The pathological diagnosis were still BOT and the recurrent sites of 10 patients were still restricted to the ovaries.Of the 12 cases, 8 cases of them had normal menstruation functions and 4 cases had less menstrual volumes or longer menstrual periods. Among 6 cases desired for pregnancy after the second operation, 4 cases of them were successful. The spontaneous pregnancy rate was 4/6. The mean duration of follow-up was 53 months (range: 23-97 months) . All recurrent BOT, three cases developed recurrence once more, two cases of them were just be hinted by B ultrasounds and only one cases was approved to be BOT again by a once more surgical pathology. But no disease related deaths occurred.
The second fertility-sparing surgery may be feasible for women with recurrent BOT who are young and strongly desired for preservation of fertility. The spontaneous pregnancy rate is satisfactory. However, carefully follow-up is still needed.
分析保留生育功能手术治疗复发性卵巢交界性肿瘤(BOT)的临床实用性及意义。
回顾性分析2002年1月至2012年12月在复旦大学附属妇产科医院收治的12例复发性BOT患者的临床及病理资料。收集并分析患者二次保守性手术后的月经情况、生育功能、复发率及生存情况。
12例患者平均发病年龄26岁,二次手术前均未生育。病理诊断仍为BOT,10例复发部位仍局限于卵巢。12例中,8例月经功能正常,4例月经量少或经期延长。二次手术后有6例有妊娠意愿,其中4例成功妊娠,自然妊娠率为4/6。平均随访时间53个月(范围:23 - 97个月)。所有复发性BOT患者中,3例再次复发,其中2例仅经B超提示,仅1例经再次手术病理确诊为BOT复发。但无疾病相关死亡发生。
对于年轻且强烈希望保留生育功能的复发性BOT患者,二次保留生育功能手术可能可行。自然妊娠率令人满意。然而,仍需仔细随访。