Kumari Sarita, Kumar Sunesh, Bhatla Neerja, Mathur Sandeep, Thulkar Sanjay, Kumar Lalit
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Gynecol Oncol Rep. 2021 Mar 23;36:100756. doi: 10.1016/j.gore.2021.100756. eCollection 2021 May.
Borderline ovarian tumor (BOT) is characterized by atypical epithelial proliferation without stromal invasion and majority are diagnosed at early stages and in women of reproductive age group. A retrospective review of medical records of patients diagnosed with BOT and on regular follow up at All India Institute of Medical Sciences New Delhi, during a five-year study period from March 2014 to March 2019 was performed. Surgical treatment was classified as radical, fertility sparing surgery (FSS) or cystectomy. Surgical staging was defined as complete, partial or unstaged. Median age of seventy-five women was 32 years. Follow up period ranged from 22 to 61 months (median 36 m). Radical surgery was done in 34 (45.3%), FSS in 32 (42.6%) and cystectomy in 9 (12.0%) women. Complete surgical staging was performed in 22 (29.3%), partial staging in 23 (30.6%) and 30 (40%) were unstaged. During the follow up period, 98.7% patients were alive and 90.7% were free of recurrence. Median time to recurrence was 35 months. Recurrence rate was 33.3% in cystectomy vs 6.2% in oophorectomy (p = 0.03). All seven recurrences were in unstaged (six) or partially staged patient (one). Six recurrences in ovary were salvaged by surgery and recurrent disease was of borderline histology. Spontaneous conception and live birth rate was 42.1%. FSS is a safe procedure and should be considered in a young patient with early stage disease and desirous of future fertility. Spontaneous conception and live birth rates after fertility sparing surgery in patients with BOT are modest.
卵巢交界性肿瘤（BOT）的特征是上皮细胞非典型增生但无间质浸润，大多数在早期被诊断出来，且患者多处于育龄期。对2014年3月至2019年3月这五年研究期间，在新德里全印度医学科学研究所被诊断为BOT并接受定期随访的患者病历进行了回顾性分析。手术治疗分为根治性手术、保留生育功能手术（FSS）或囊肿切除术。手术分期分为完全分期、部分分期或未分期。75名女性的中位年龄为32岁。随访期为22至61个月（中位36个月）。34名（45.3%）女性接受了根治性手术，32名（42.6%）接受了FSS，9名（12.0%）接受了囊肿切除术。22名（29.3%）患者进行了完全手术分期，23名（30.6%）进行了部分分期，30名（40%）未分期。在随访期间，98.7%的患者存活，90.7%的患者无复发。复发的中位时间为35个月。囊肿切除术的复发率为33.3%，而卵巢切除术的复发率为6.2%（p = 0.03）。所有7例复发均发生在未分期（6例）或部分分期（1例）的患者中。6例卵巢复发通过手术得到挽救，复发病变为交界性组织学类型。自然受孕和活产率为42.1%。保留生育功能手术是一种安全的手术方式，对于患有早期疾病且渴望未来生育的年轻患者应予以考虑。BOT患者保留生育功能手术后的自然受孕和活产率一般。
