Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Stockholm, Sweden.
Department of Obstetrics and Gynecology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Fertil Steril. 2021 Jan;115(1):157-163. doi: 10.1016/j.fertnstert.2020.07.043. Epub 2020 Sep 22.
To assess the efficacy of fertility-sparing surgery (FSS) in terms of reproductive outcomes by following FSS for borderline ovarian tumors (BOTs) and comparing the safety of FSS versus radical surgery (RS).
Nationwide cohort study based on prospectively recorded data.
Sweden.
PATIENT (S): All women of reproductive age (18-40 years) treated in Sweden for stage I BOT with the use of FSS or RS from 2008 to 2015, identified in the Swedish Quality Registry for Gynecologic Cancer (SQRGC).
INTERVENTIONS (S): FSS or RS.
MAIN OUTCOME MEASURE (S): Reproductive outcomes: natural conception, use of assisted reproductive technology (ART), live birth and obstetrical outcomes. Safety outcome: overall survival (OS) rates, comparing women undergoing FSS versus RS. The FSS cohort was linked to the Swedish Medical Birth Register to identify all women who had given birth after FSS and to obtain detailed obstetrical data. For information on ART treatment, the National Quality Registry for Assisted Reproduction was consulted. OS rate comparisons were conducted by means of Kaplan-Meier estimates.
RESULT (S): Of the 277 women with BOTs, 213 (77%) underwent FSS, 183 (86%) unilateral salpingo-oophorectomy, and 30 (14%) cystectomy. Following FSS, 50 women gave birth to 62 healthy children, 8% of which were preterm. Only 20 (9%) of the women underwent ART treatment. OS was similar in women treated with FSS and RS.
CONCLUSION (S): Natural fertility was maintained after FSS; only 9% required ART treatment. FSS was also deemed to be equivalent to RS regarding survival outcome.
通过对接受交界性卵巢肿瘤（BOT）保留生育功能手术（FSS）的患者进行随访，并比较 FSS 与根治性手术（RS）的安全性，评估 FSS 在生殖结局方面的疗效。
基于前瞻性记录数据的全国性队列研究。
瑞典。
2008 年至 2015 年期间，在瑞典接受 FSS 或 RS 治疗的所有年龄在 18-40 岁之间的生育期妇女，这些患者均在瑞典妇科癌症质量登记处（SQRGC）中被诊断为 I 期 BOT。
FSS 或 RS。
生殖结局：自然妊娠、使用辅助生殖技术（ART）、活产和产科结局。安全性结局：总生存率（OS），比较接受 FSS 与 RS 的患者。将 FSS 队列与瑞典医疗出生登记处进行关联，以识别所有接受 FSS 治疗后分娩的妇女，并获取详细的产科数据。对于 ART 治疗信息，咨询了国家辅助生殖质量登记处。通过 Kaplan-Meier 估计进行 OS 率比较。
在 277 例 BOT 患者中，213 例（77%）接受了 FSS，183 例（86%）行单侧输卵管卵巢切除术，30 例（14%）行囊肿切除术。FSS 后，50 名妇女产下 62 名健康儿童，其中 8%为早产儿。只有 20 名（9%）妇女接受了 ART 治疗。接受 FSS 和 RS 治疗的患者 OS 相似。
FSS 后可维持自然生育力，仅 9%需要 ART 治疗。FSS 在生存结局方面也被认为与 RS 等效。
