Wang Liya, Huang Shenjiao, Sheng Xiujie, Ren Chenchen, Wang Qiming, Yang Linqing, Zhao Shuping, Xu Tianmin, Ma Xiaoxin, Guo Ruixia, Sun Pengming, Lin Yang, Li Yuhong, Wang Jiandong, Wang Yudong
Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Municipal Key Clinical Specialty, Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, People's Republic of China.
Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Centre, Guangzhou 510623, People's Republic of China.
Cancer Manag Res. 2020 Oct 29;12:10841-10848. doi: 10.2147/CMAR.S271806. eCollection 2020.
The aim of this study was to investigate the clinical characteristics and management of malignant ovarian tumors during pregnancy, as well as the feto-maternal outcomes and analyze the influential factors on the pregnancy outcomes.
Eighty-five patients with ovarian malignancies during pregnancy treated at 12 tertiary hospitals between 2009 and 2019 were analyzed in this study. The clinical features, histopathological characteristics, clinical management, and maternal and perinatal outcomes were retrospectively analyzed. The clinical features and managements were compared between abortion group and live birth group.
The following diagnoses were made: 41 (48.24%) patients with borderline ovarian tumors, 18 (21.18%) patients with epithelial ovarian cancers, 17 (20.00%) patients with non-epithelial ovarian malignancies and 9 (10.59%) patients with metastatic ovarian tumors. Thirty-six (42.45%) patients underwent conservative surgical treatment. Thirty-four (40.00%) patients opted for fertility-sparing surgery, and fifteen (17.56%) patients received radical surgery. Chemotherapy was administered to 32.94% of the patients. The proportion of ovarian malignancies diagnosed in the first trimester in the abortion group was higher than that in the live birth group (<0.05). However, tumor diameter, reproductive history, stage and surgical indications showed no significant differences between groups. A total of 67 live babies were recorded in this study, including 19 premature babies and 1 full-term newborn who died of respiratory distress. All of the BOTs were diagnosed with stage I, among whom 38 (92.68%) patients exhibited disease-free survival. Twenty-eight ovarian cancers were in stage I-II and 26 of them had disease-free survival with the longest follow-up time of 10 years. Five of the sixteen patients in advanced stage (stage III-IV) died, four of whom had metastatic tumors.
Pregnant women with early-stage malignant ovarian tumors appear to have favorable outcomes. Conservative surgery is acceptable for early-stage borderline ovarian tumors during pregnancy. The gestational age of ovarian malignancy detection is key for pregnancy outcomes.
本研究旨在探讨妊娠期间恶性卵巢肿瘤的临床特征与管理，以及母婴结局，并分析影响妊娠结局的因素。
本研究分析了2009年至2019年间在12家三级医院接受治疗的85例妊娠合并卵巢恶性肿瘤患者。对其临床特征、组织病理学特征、临床管理以及母婴和围产期结局进行回顾性分析。比较流产组和活产组的临床特征及管理情况。
做出以下诊断：41例（48.24%）为卵巢交界性肿瘤患者，18例（21.18%）为上皮性卵巢癌患者，17例（20.00%）为非上皮性卵巢恶性肿瘤患者，9例（10.59%）为转移性卵巢肿瘤患者。36例（42.45%）患者接受了保守性手术治疗。34例（40.00%）患者选择了保留生育功能手术，15例（17.56%）患者接受了根治性手术。32.94%的患者接受了化疗。流产组妊娠早期诊断出的卵巢恶性肿瘤比例高于活产组（<0.05）。然而，肿瘤直径、生育史、分期和手术指征在两组之间无显著差异。本研究共记录了67例活产婴儿，其中19例为早产儿，1例足月新生儿死于呼吸窘迫。所有卵巢交界性肿瘤均诊断为Ⅰ期，其中38例（92.68%）患者无病生存。28例卵巢癌处于Ⅰ - Ⅱ期，其中26例无病生存，最长随访时间为10年。16例晚期（Ⅲ - Ⅳ期）患者中有5例死亡，其中4例患有转移性肿瘤。
早期恶性卵巢肿瘤的孕妇似乎有良好的结局。妊娠期间早期卵巢交界性肿瘤行保守性手术是可以接受的。卵巢恶性肿瘤检测的孕周是妊娠结局的关键。
