Oh Sumin, Kim Ran, Lee Yoo-Kyung, Kim Jae Weon, Park Noh-Hyun, Song Yong-Sang
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2015 Mar;58(2):98-105. doi: 10.5468/ogs.2015.58.2.98. Epub 2015 Mar 16.
Despite the good prognosis of borderline ovarian tumors (BOTs), a few BOT patients experience the relapse of disease, either borderline or malignant. However, the risk of recurrence of BOTs is somewhat controversial. We intended to find out the specific characteristics and prognosis of the recurrence of BOTs.
Between 1995 and 2012, 130 women were diagnosed with BOTs at a single institution. Eleven patients diagnosed and treated for the recurrence of BOTs including seven cancerous and four borderline relapses were included for the analysis in this retrospective study. Clinicopathological characteristics and surgical procedures as well as follow-up data with overall survival were assessed. Statistical analyses was performed using the χ(2) test, t-test and log-rank test with Cox regression.
One hundred and thirty patients with mean follow-up of 65.8 months were evaluated, of whom half were below 40 years old at their first diagnosis of BOTs. Among 11 recurrent cases (8.5%), 7 cancerous transformations (5.4%) and 4 borderline recurrences (3.1%) were detected with median time of 6 and 71 months after the primary surgery, respectively. Nine out of 11 recurrences were happened at their equal or below 40-years-old age at the primary diagnosis (P=0.027). Also, all 7 cancerous relapses arose from premenopausal women of median age of 35 years old. Twenty (15%) patients had laparoscopic surgery and they were all treated conservatively. Among those 20, 5 were suffered from relapse of BOTs and laparoscopic approach was proved to be a significant risk factor for disease relapse in our study (P=0.013). Although laparoscopic surgery was revealed had meaningful influence on disease free survival (P=0.024), it was not significant on overall survival (P=0.226).
Laparoscopic conservative surgery for BOTs can be accepted under close follow-ups. And younger patients should be followed for long period to evaluate recurrence.
尽管卵巢交界性肿瘤（BOTs）预后良好，但仍有少数BOT患者会出现疾病复发，包括交界性或恶性复发。然而，BOTs的复发风险存在一定争议。我们旨在找出BOTs复发的具体特征和预后情况。
1995年至2012年间，一家机构诊断出130例BOTs患者。本回顾性研究纳入了11例诊断并治疗BOTs复发的患者，其中包括7例癌变复发和4例交界性复发。评估了临床病理特征、手术方式以及总生存的随访数据。采用χ(2)检验、t检验和Cox回归的对数秩检验进行统计学分析。
对130例患者进行了评估，平均随访65.8个月，其中一半患者首次诊断BOTs时年龄在40岁以下。在11例复发病例（8.5%）中，分别在初次手术后6个月和71个月检测到7例癌变（5.4%）和4例交界性复发（3.1%）。11例复发中有9例发生在初次诊断时年龄等于或低于40岁（P = 0.027）。此外，所有7例癌变复发均发生在中位年龄为35岁的绝经前女性中。20例（15%）患者接受了腹腔镜手术，且均采用保守治疗。在这20例患者中，有5例发生了BOTs复发，在我们的研究中，腹腔镜手术被证明是疾病复发的一个重要危险因素（P = 0.013）。虽然腹腔镜手术对无病生存有显著影响（P = 0.024），但对总生存无显著影响（P = 0.226）。
BOTs的腹腔镜保守手术在密切随访下是可以接受的。年轻患者应长期随访以评估复发情况。
