Ozenne Adele, De Berti Marion, Body Gilles, Carcopino Xavier, Graesslin Olivier, Kerbage Yohan, Akladios Cherif, Huchon Cyrille, Bricou Alexandre, Mimoun Camille, Raimond Emilie, Ouldamer Lobna
Department of Gynecology, Tours University Hospital, 37044 Tours, France.
INSERM U1069, Université François-Rabelais, 37044 Tours, France.
J Clin Med. 2022 Jun 23;11(13):3645. doi: 10.3390/jcm11133645.
Borderline ovarian tumours (BOT) represent 10-20% of epithelial tumours of the ovary. Although their prognosis is excellent, the recurrence rate can be as high as 30%, and recurrence in the infiltrative form accounts for 3% to 5% of recurrences. Affecting, in one third of cases, women of childbearing age, the surgical strategy with ovarian conservation is now recommended despite a significant risk of recurrence. Few studies have focused exclusively on patients who have received ovarian conservative treatment in an attempt to identify factors predictive of recurrence and the impact on fertility. The objective of this study was to identify the risk factors for recurrence of BOT after conservative treatment and the impact on fertility.
This was a retrospective, multicentre study of women who received conservative surgery for BOT between February 1997 and September 2020. We divided the patients into two groups, the "R group" with recurrence and the "NR group" without recurrence.
Of 175 patients included, 35 had a recurrence (R group, 20%) and 140 had no recurrence (NR group, 80%). With a mean follow-up of 30 months (IQ 8-62.5), the overall recurrence rate was 20%. Recurrence was BOT in 17.7% (31/175) and invasive in 2.3% (4/175). The mean time to recurrence was 29.5 months (IQ 16.5-52.5). Initial complete peritoneal staging (ICPS) was performed in 42.5% of patients ( = 75). In multivariate analysis, age at diagnosis, nulliparity, advanced FIGO stage, the presence of peritoneal implants, and the presence of a micropapillary component for serous tumours were factors influencing the occurrence of recurrence. The post-surgery fertility rate was 67%.
This multicentre study is to date one of the largest studies analysing the risk factors for recurrence of BOT after conservative surgery. Five risk factors were found: age at diagnosis, nulliparity, advanced FIGO stage, the presence of implants, and a micropapillary component. Only 25% of the patients with recurrence underwent ICPS. These results reinforce the interest of initial peritoneal staging to avoid ignoring an advanced tumour stage.
卵巢交界性肿瘤（BOT）占卵巢上皮性肿瘤的10%-20%。尽管其预后良好，但复发率可高达30%，浸润性复发占复发的3%至5%。三分之一的病例发生在育龄妇女，尽管复发风险很高，但目前仍建议采取保留卵巢的手术策略。很少有研究专门针对接受卵巢保守治疗的患者，以试图确定预测复发的因素及其对生育能力的影响。本研究的目的是确定保守治疗后BOT复发的危险因素及其对生育能力的影响。
这是一项对1997年2月至2020年9月间接受BOT保守手术的女性进行的回顾性多中心研究。我们将患者分为两组，“R组”为复发组，“NR组”为未复发组。
纳入的175例患者中，35例复发（R组，20%），140例未复发（NR组，80%）。平均随访30个月（四分位间距8-62.5个月），总体复发率为20%。BOT复发占17.7%（31/175），浸润性复发占2.3%（4/175）。复发的平均时间为29.5个月（四分位间距16.5-52.5个月）。42.5%的患者（n = 75）进行了初始全面腹膜分期（ICPS）。多因素分析显示，诊断时年龄、未生育、国际妇产科联盟（FIGO）分期晚期、腹膜种植以及浆液性肿瘤的微乳头成分是影响复发发生的因素。术后生育率为67%。
这项多中心研究是迄今为止分析BOT保守手术后复发危险因素的最大规模研究之一。发现了五个危险因素：诊断时年龄、未生育、FIGO分期晚期、种植的存在以及微乳头成分。复发患者中只有25%接受了ICPS。这些结果强化了初始腹膜分期的意义，以避免忽视晚期肿瘤分期。
