Department of Gynecologic Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Street, 02-781 Warsaw, Poland.
Department of Gynecologic Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Street, 02-781 Warsaw, Poland.
Eur J Obstet Gynecol Reprod Biol. 2022 Feb;269:126-131. doi: 10.1016/j.ejogrb.2021.12.029. Epub 2021 Dec 30.
The main goal of fertility-sparing treatment is pregnancy followed by live birth (i.e., successful pregnancy). The principal objective of our study was to evaluate the successful pregnancy rate in patients with borderline ovarian tumors (BOTs) after conservative treatment. The second goal was to evaluate the safety of the conservative approach.
110 patients with BOT were retrospectively evaluated. All patients underwent surgical treatment, sparing the uterus and part of at least one ovary.
The median age was 28 years (range 17-40 years). Serous and mucinous tumors were found in 63 (57%) and 34 (31%) women, respectively. FIGO stage I, II, and III was diagnosed in 101 (91.8%), 3 (2.7%), and 6 (5.5%) patients, respectively. The 3- and 5-year progression-free survival was 82.5% and 78.2%, respectively. Recurrent disease was treated conservatively in 14 women, whereas 3 patients underwent radical surgery. Fifty-six (50.9%) patients got pregnant and had at least one live birth. A total of 83 children were born. A significant difference in the successful pregnancy rate was found in patients diagnosed ≤ 35 years vs. > 35 years old (55.6% vs. 9.1%, respectively; p = 0.003). Surgical approach (laparoscopy vs. laparotomy) did not influence the chance of childbirth. Pre-term delivery constituted 6.25% of all births.
Fertility-sparing surgery should be proposed to young women wishing to preserve fertility. The rate of spontaneous pregnancy is approximately 50%.The risk of relapse is significant but always of borderline histology and may be successfully treated by the second surgery.
保留生育能力治疗的主要目标是妊娠并随后活产（即成功妊娠）。我们研究的主要目的是评估在接受保守治疗后患有交界性卵巢肿瘤（BOT）的患者的成功妊娠率。第二个目标是评估保守方法的安全性。
回顾性评估了 110 例 BOT 患者。所有患者均接受了手术治疗，保留了子宫和至少一侧卵巢的一部分。
中位年龄为 28 岁（范围 17-40 岁）。63 例（57%）和 34 例（31%）患者分别发现浆液性和黏液性肿瘤。FIGO 分期 I、II 和 III 分别诊断为 101 例（91.8%）、3 例（2.7%）和 6 例（5.5%）患者。3 年和 5 年无进展生存率分别为 82.5%和 78.2%。14 例患者接受了保守治疗，而 3 例患者接受了根治性手术。56 例（50.9%）患者怀孕并至少有一次活产。共出生 83 名儿童。在诊断年龄≤35 岁的患者与>35 岁的患者之间，成功妊娠率存在显著差异（分别为 55.6%和 9.1%；p=0.003）。手术方式（腹腔镜与剖腹手术）并不影响分娩机会。早产构成所有分娩的 6.25%。
应向希望保留生育能力的年轻女性提出保留生育能力的手术。自然妊娠率约为 50%。复发的风险是显著的，但总是交界性组织学，可以通过第二次手术成功治疗。
