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手术分期对卵巢黏液性交界性肿瘤预后的影响:一项多中心研究

The Impact of Surgical Staging on the Prognosis of Mucinous Borderline Tumors of the Ovaries: A Multicenter Study.

作者信息

Gungorduk Kemal, Asicioglu Osman, Braicu Elena Ioana, Almuheimid Jumana, Gokulu Sevki Goksun, Cetinkaya Nilufer, Gungor Tayfun, Pakay Gonca, Telli Elcin Uzmez, Cuylan Zeliha Firat, Toptas Tayfun, Bilgi Ahmet, Ozyurt Ramazan, Agacayak Elif, Ozdemir Aykut, Yildirim Nuri, Taskin Salih, Oge Tufan, Erol Onur, Akman Levent, Turan Anil, Icen Mehmet Sait, Senol Taylan, Ovali Ozlem Irak, Yucesoy Burcu, Gungorduk Ozgu, Temizkan Osman, Sanci Muzaffer, Simsek Tayup, Meydanli Mehmet Mutlu, Harma Mehmet, Yasar Levent, Uysal Aysel Derbent, Karateke Ates, Ortac Firat, Ozalp Sabit Sinan, Sehouli Jalid, Muallem Mustafa Zelal

机构信息

Department of Gynecology and Gynecologic Oncology, Mugla Education and Research Hospital, Mugla, Turkey.

Department of Gynecology and Gynecologic Oncology, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey.

出版信息

Anticancer Res. 2017 Oct;37(10):5609-5616. doi: 10.21873/anticanres.11995.

Abstract

BACKGROUND/AIM: The purpose of this study was to prove the effect of complete surgical staging of patients with mucinous borderline ovarian tumors (mBOTs) especially appendectomy on progression-free survival (PFS) and overall survival (OS).

PATIENTS AND METHODS

The database of 14 gynecological oncology departments from Turkey and Germany were comprehensively searched for women who underwent primary surgery for an ovarian tumor between January 1, 1998, and December 31, 2015, and whose final diagnosis was mBOT.

RESULTS

A total of 364 patients with mBOT with a median age of 43.1 years were included in this analysis. The median OS of all patients was 53.1 months. The majority of cases had Stage IA (78.6%). In univariate and multivariate analyses, radical surgery, omentectomy, appendectomy, lymphadenectomy, and adding adjuvant chemotherapy were not independent prognostic factors for PFS and OS. Furthermore, FIGO stage (≥IC vs. <IC), radical surgery, and staging surgery were not independent risk factors for recurrence of mBOTs. Finally, abnormal macroscopic appendix and FIGO stage (≥IC vs. <IC) were independent risk factors for appendiceal involvement (p=0.032).

CONCLUSION

Patients with conservative surgery do not have higher recurrence rates. Fertility-sparing surgery should be considered in the reproductive age group. Detailed surgical staging including lymphadenectomy, appendectomy, and omentectomy does not have an impact on survival rates.

摘要

背景/目的:本研究的目的是证实黏液性交界性卵巢肿瘤(mBOT)患者进行完整手术分期,尤其是阑尾切除术对无进展生存期(PFS)和总生存期(OS)的影响。

患者与方法

全面检索了土耳其和德国14个妇科肿瘤科室的数据库,以查找1998年1月1日至2015年12月31日期间因卵巢肿瘤接受初次手术且最终诊断为mBOT的女性患者。

结果

本分析共纳入364例mBOT患者,中位年龄为43.1岁。所有患者的中位总生存期为53.1个月。大多数病例为IA期(78.6%)。在单因素和多因素分析中,根治性手术、大网膜切除术、阑尾切除术、淋巴结切除术以及加用辅助化疗并非PFS和OS的独立预后因素。此外,国际妇产科联盟(FIGO)分期(≥IC期与<IC期)、根治性手术和分期手术并非mBOT复发的独立危险因素。最后,阑尾肉眼观异常和FIGO分期(≥IC期与<IC期)是阑尾受累的独立危险因素(p=0.032)。

结论

接受保守手术的患者复发率并不更高。对于育龄期患者应考虑保留生育功能的手术。包括淋巴结切除术、阑尾切除术和大网膜切除术在内的详细手术分期对生存率无影响。

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