Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
I-Cube UMR 7357-Laboratoire des Sciences de L'ingénieur, de L'informatique et de L'imagerie, Université de Strasbourg, Strasbourg, France.
Ann Surg Oncol. 2021 Nov;28(12):7616-7623. doi: 10.1245/s10434-021-09852-9. Epub 2021 Apr 26.
Borderline ovarian tumors (BOTs) are tumors with a favorable prognosis but whose management by consensus is essential to limit the risk of invasive recurrence. This study aimed to conduct an inventory of surgical practices for BOT in France and to evaluate the conformity of the treatment according to the current French guidelines.
This retrospective, multicenter cohort study included nine referral centers of France between January 2001 and December 2018. It analyzed all patients with serous and mucinous BOT who had undergone surgery. A peritoneal staging in accordance with the recommendations was defined by performance of a peritoneal cytology, an omentectomy, and at least one peritoneal biopsy.
The study included 332 patients. A laparoscopy was performed in 79.5% of the cases. Treatment was conservative in 31.9% of the cases. The recurrence rate was significantly increased after conservative treatment (17.3% vs 3.1%; p < 0.001). Peritoneal cytology was performed for 95.5%, omentectomy for 83.1%, and at least one biopsy for 82.2% of the patients. The overall recurrence rate was 7.8%, and the recurrence was invasive in 1.2% of the cases. No link was found between the recurrence rate and the conformity of peritoneal staging. The overall rate of staging noncompliance was 22.9%.
The current standards for BOT management seem to be well applied.
交界性卵巢肿瘤（BOT）是一种预后良好的肿瘤，但需要通过共识来管理，以限制浸润性复发的风险。本研究旨在对法国的 BOT 手术实践进行盘点，并评估根据当前法国指南进行治疗的一致性。
这是一项回顾性、多中心队列研究，包括法国 9 个转诊中心，时间为 2001 年 1 月至 2018 年 12 月。研究分析了所有接受手术治疗的浆液性和黏液性 BOT 患者。根据建议进行腹膜分期，包括进行腹膜细胞学检查、网膜切除术和至少一次腹膜活检。
研究共纳入 332 例患者。79.5%的病例采用腹腔镜手术。31.9%的病例采用保守治疗。保守治疗后复发率显著增加（17.3%比 3.1%；p<0.001）。95.5%的患者进行了腹膜细胞学检查，83.1%的患者进行了网膜切除术，82.2%的患者进行了至少一次活检。总的复发率为 7.8%，侵袭性复发率为 1.2%。腹膜分期的一致性与复发率之间没有联系。分期不符合标准的总体发生率为 22.9%。
目前 BOT 管理的标准似乎得到了很好的应用。
