Yoshikawa Nobuhisa, Teshigawara Toshiya, Ikeda Yoshiki, Nishino Kimihiro, Sakata Jun, Utsumi Fumi, Niimi Kaoru, Sekiya Ryuichiro, Suzuki Shiro, Kawai Michiyasu, Shibata Kiyosumi, Kikkawa Fumitaka, Kajiyama Hiroaki
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Obstetrics and Gynecology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan.
Oncotarget. 2018 Jun 8;9(44):27564-27573. doi: 10.18632/oncotarget.25548.
The purpose of this study was to evaluate the long-term clinical outcome of young women with malignant transformation arising from mature cystic teratoma of the ovary (MT-MCT) by comparing radical surgery and fertility-sparing surgery (FSS).
All patients treated with radical surgery or FSS for MT-MCT in multiple institutions were registered in this analysis. Univariate and multivariate analyses were performed to evaluate clinical outcome, including overall survival (OS) and disease-free survival (DFS).
From 1986 to 2016, 62 patients with MT-MCT were treated in our group. The median follow-up period was 38.0 (2.0-227.9) months, and the median age was 54 (17-82) years old. Multivariate analysis revealed that only advanced stage was significantly correlated with poorer prognosis of patients [hazard ratio (HR) for death: 6.58, 95% confidence interval (CI): 1.82-24.78, P = 0.0048; HR for recurrence: 5.59, 95% CI: 1.52-21.83, P = 0.01]. Of a total of 13 women with stage I-II disease at less than 45 years old, 7 were treated with FSS, and there was no recurrence except for in one woman with stage II MT-MCT. There was no significant difference in long-term oncological outcome between radical surgery and FSS.
FSS may be indicated for patients with stage I MT-MCT, who hope to preserve fertility, as no relapse was found after FSS.
本研究旨在通过比较根治性手术和保留生育功能手术（FSS），评估卵巢成熟性囊性畸胎瘤恶变（MT-MCT）的年轻女性的长期临床结局。
本分析纳入了多家机构接受根治性手术或FSS治疗MT-MCT的所有患者。进行单因素和多因素分析以评估临床结局，包括总生存期（OS）和无病生存期（DFS）。
1986年至2016年，我们组共治疗了62例MT-MCT患者。中位随访期为38.0（2.0 - 227.9）个月，中位年龄为54（17 - 82）岁。多因素分析显示，仅晚期与患者较差的预后显著相关[死亡风险比（HR）：6.58，95%置信区间（CI）：1.82 - 24.78，P = 0.0048；复发HR：5.59，95% CI：1.52 - 21.83，P = 0.01]。在13例年龄小于45岁的I-II期疾病女性中，7例接受了FSS治疗，除1例II期MT-MCT女性外无复发。根治性手术和FSS之间的长期肿瘤学结局无显著差异。
对于希望保留生育功能的I期MT-MCT患者，FSS可能是合适的，因为FSS后未发现复发。
