对于交界性卵巢肿瘤患者，进行子宫切除术是否合理？
Is there a justification for hysterectomy in patients with borderline ovarian tumors?
作者信息
Ouldamer L, Lacoste C, Cormier B, Arbion F, Marret H, Jallais L, Fignon A, Body G
机构信息
Department of Gynecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, 2 boulevard Tonnellé, 37044, Tours, France; INSERM Unit 1069, Tours, France; François-Rabelais University, Tours, France.
Department of Gynecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, 2 boulevard Tonnellé, 37044, Tours, France; François-Rabelais University, Tours, France.
出版信息
Surg Oncol. 2016 Mar;25(1):1-5. doi: 10.1016/j.suronc.2015.11.004. Epub 2015 Nov 12.
OBJECTIVE
To determine the frequency of uterine involvement in patients with borderline ovarian tumors (BOT) and to evaluate the recurrence risk and survival after hysterectomy.
MATERIALS AND METHODS
In two French hospitals: A tertiary referral centre (University hospital centre of Tours, France) and the Alliance community hospital of Tours (France), we reviewed data of consecutive women undergoing surgery for presumed stage I BOT between January 1997 and December 2012. Patients were divided into two groups: patients treated with fertility sparing surgery (group 1) and those treated with radical surgery (group 2).
RESULTS
A total of 135 patients were evaluated. 35 had fertility sparing surgery, 81 had radical surgery with hysterectomy and 19 had previous hysterectomy for other reasons. There were more recurrent borderline ovarian disease and more ovarian invasive disease developed in group 1 (p = 0.02, p = 0.04, respectively). Hysterectomy affected favorably borderline disease-free survival, OR = 0.09 95%CI (0.005-0.69), p = 0.04, but perceived benefits may be related to bilateral salpingo-oophorectomy and not hysterectomy directly.
目的
确定卵巢交界性肿瘤（BOT）患者子宫受累的频率，并评估子宫切除术后的复发风险和生存率。
材料与方法
在法国的两家医院：一家三级转诊中心（法国图尔大学医院中心）和图尔市联盟社区医院，我们回顾了1997年1月至2012年12月期间因疑似I期BOT接受手术的连续女性患者的数据。患者分为两组：接受保留生育功能手术的患者（第1组）和接受根治性手术的患者（第2组）。
结果
共评估了135例患者。35例行保留生育功能手术，81例行根治性子宫切除手术，19例因其他原因曾行子宫切除术。第1组出现更多的卵巢交界性疾病复发和更多的卵巢浸润性疾病（分别为p = 0.02，p = 0.04）。子宫切除术对无交界性疾病生存期有有利影响，OR = 0.09，95%CI（0.005 - 0.69），p = 0.04，但观察到的益处可能与双侧输卵管卵巢切除术有关，而非直接与子宫切除术有关。
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