Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China.
Department of Gynecologic Oncology, Women's Hospital, Zhejiang University, Hangzhou, 310006, China.
Front Med. 2018 Oct;12(5):509-517. doi: 10.1007/s11684-017-0554-3. Epub 2017 Dec 7.
This study was performed to evaluate the oncological and reproductive outcomes of childbearing-age women treated with fertility-sparing surgery (FSS) for non-epithelial ovarian tumors in China. One hundred and forty eight non-epithelial ovarian tumor women treated with FSS between January 1, 2000 and August 31, 2015 from two medical centers in China were identified. Progression-free survival (PFS) was 88.5%, whereas overall survival (OS) was 93.9%. Univariate analysis suggested that delivery after treatment is related to PFS (P = 0.023), whereas histology significantly influenced OS. Cox regression analysis suggested that only histology was associated with PFS and OS (P < 0.05). Among the 129 women who completed adjuvant chemotherapy (ACT), none developed amenorrhea. Among the 44 women who desired pregnancy, 35 (79.5%) successfully had 51 gestations including 35 live births without birth defects. Non-epithelial ovarian tumors can achieve fulfilling prognosis after FSS and chemotherapy. Histology might be the only independent prognostic factor for PFS and OS. FSS followed by ACT appeared to have little or no effect on fertility. Meanwhile, postoperative pregnancy did not increase the PFS or OS. Use of gonadotropin-releasing hormone agonist was not beneficial for fertility.
这项研究旨在评估在中国接受保留生育功能手术（FSS）治疗的非上皮性卵巢肿瘤的育龄妇女的肿瘤学和生殖结局。在中国的两个医疗中心，于 2000 年 1 月 1 日至 2015 年 8 月 31 日期间，确定了 148 名接受 FSS 治疗的非上皮性卵巢肿瘤女性。无进展生存期（PFS）为 88.5%，总生存期（OS）为 93.9%。单因素分析表明，治疗后分娩与 PFS 相关（P=0.023），而组织学显著影响 OS。Cox 回归分析表明，只有组织学与 PFS 和 OS 相关（P<0.05）。在完成辅助化疗（ACT）的 129 名妇女中，没有出现闭经。在 44 名希望怀孕的妇女中，35 名（79.5%）成功妊娠 51 次，包括 35 次活产，无出生缺陷。非上皮性卵巢肿瘤在接受 FSS 和化疗后可获得良好的预后。组织学可能是 PFS 和 OS 的唯一独立预后因素。FSS 后加用 ACT 似乎对生育能力影响很小或没有影响。同时，术后妊娠并未增加 PFS 或 OS。使用促性腺激素释放激素激动剂对生育无益。
