Lee Jung-Yun, Jo Yu Ri, Kim Tae Hun, Kim Hee Seung, Kim Min A, Kim Jae Weon, Park Noh Hyun, Song Yong-Sang
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
Cancer Res Treat. 2015 Apr;47(2):290-7. doi: 10.4143/crt.2014.004. Epub 2014 Aug 29.
The aim of this study is to evaluate the safety of fertility-sparing surgery as the treatment for patients with primary mucinous epithelial ovarian cancer.
A retrospective study of patients with mucinous ovarian cancer between 1991 and 2010 was performed. The demographics and survival outcomes were compared between patients who underwent fertility-sparing surgery and those who underwent radical surgery.
A total of 110 patients underwent primary surgery. At the time of surgery, tumors appeared to be grossly confined to the ovaries in 90 patients, and evidence of metastasis was definite in 20 patients. Of the 90 patients with tumors that appeared to be grossly confined to the ovaries at surgical exploration, 35 (38.9%) underwent fertility-sparing surgery. The Kaplan- Meier curve and the log rank test showed no difference in either recurrence-free survival (p=0.792) or disease-specific survival (p=0.706) between the two groups. Furthermore, there was no significant difference in recurrence-free survival (p=0.126) or disease-specific survival (p=0.377) between the two groups, even when the analysis was limited to women below the age of 40. In a multivariate Cox model, fertility-sparing surgery had no effect on either recurrence-free survival (recurrence hazard ratio [HR], 1.20; 95% confidence interval [CI], 0.25 to 5.71) or disease-specific survival (death HR, 0.88; 95% CI, 0.17 to 4.60).
Fertility-sparing surgery in primary mucinous cancer grossly confined to the ovaries may be a safe option and one not associated with an increase in recurrence or mortality.
本研究旨在评估保留生育功能手术治疗原发性黏液性上皮性卵巢癌患者的安全性。
对1991年至2010年间黏液性卵巢癌患者进行回顾性研究。比较接受保留生育功能手术的患者与接受根治性手术的患者的人口统计学和生存结局。
共有110例患者接受了初次手术。手术时，90例患者的肿瘤肉眼可见局限于卵巢，20例患者有明确的转移证据。在手术探查时肿瘤肉眼可见局限于卵巢的90例患者中，35例（38.9%）接受了保留生育功能手术。Kaplan-Meier曲线和对数秩检验显示，两组之间的无复发生存率（p = 0.792）或疾病特异性生存率（p = 0.706）均无差异。此外，即使将分析仅限于40岁以下的女性，两组之间的无复发生存率（p = 0.126）或疾病特异性生存率（p = 0.377）也无显著差异。在多变量Cox模型中，保留生育功能手术对无复发生存率（复发风险比[HR]，1.20；95%置信区间[CI]，0.25至5.71）或疾病特异性生存率（死亡HR，0.88；95%CI，0.17至4.60）均无影响。
对于肉眼可见局限于卵巢的原发性黏液性癌，保留生育功能手术可能是一种安全的选择，且不会增加复发或死亡率。
