Abdallah Reem, Chamsy Dina, Dagher Christian, Hajjar Rima, El Housheimi Alaa, Seoud Muhieddine, Khalil Ali
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
J Obstet Gynaecol. 2022 Nov;42(8):3600-3604. doi: 10.1080/01443615.2022.2130204. Epub 2022 Oct 17.
Borderline ovarian tumours (BOTs) commonly affect young nulliparous women, thus making fertility-preserving approaches more desirable. Women who opt for conservative management should be counselled about disease recurrence. In this retrospective study, the medical records of 57 women with BOT treated at the American University of Beirut Medical Centre between January 1986 and May 2018 were reviewed. Clinical, pathologic, and demographic data were collected and analysed to identify variables associated with poor clinical outcomes including advanced disease and risk of recurrence. Younger and nulliparous women were more likely to undergo fertility-sparing surgery. The open approach was adopted for women with larger adnexal masses and was associated with more blood loss with a mean difference of 172 mL (95% CI [110-235], -value < .001) but no significant difference in operative time and length of hospital stay compared to the laparoscopic approach. CA-125 correlated with an advanced International Federation of Gynaecology and Obstetrics (FIGO) stage ( = .004). The recurrence rate was found to be 7% with a median recurrence time of 41.5 months.IMPACT STATEMENT BOTs are common in young nulliparous women who often desire fertility-sparing procedures. Prognostic factors associated with disease severity and recurrence remain controversial. This study presents an opportunity to understand the disease behaviour and compare local practices and outcomes to what was reported in the literature. CA-125 appears to be a useful marker in predicting the stage of BOT. Future research should focus on exploring whether BOTs with micropapillary features represent an aggressive histologic subtype more prone to recurrence.
卵巢交界性肿瘤（BOTs）通常影响年轻未生育女性，因此保留生育功能的治疗方法更受青睐。选择保守治疗的女性应接受关于疾病复发的咨询。在这项回顾性研究中，我们回顾了1986年1月至2018年5月期间在美国贝鲁特美国大学医学中心接受治疗的57例BOT患者的病历。收集并分析了临床、病理和人口统计学数据，以确定与不良临床结局相关的变量，包括疾病进展和复发风险。年轻未生育女性更有可能接受保留生育功能的手术。对于附件包块较大的女性采用开放手术方式，与更多的失血量相关，平均差异为172 mL（95%CI[110 - 235]，P值<0.001），但与腹腔镜手术相比，手术时间和住院时间无显著差异。CA - 125与国际妇产科联合会（FIGO）晚期分期相关（P = 0.004）。复发率为7%，中位复发时间为41.5个月。影响声明BOTs在经常希望采用保留生育功能手术的年轻未生育女性中很常见。与疾病严重程度和复发相关的预后因素仍存在争议。本研究提供了一个机会来了解疾病行为，并将当地的实践和结果与文献报道进行比较。CA - 125似乎是预测BOT分期的一个有用标志物。未来的研究应集中于探索具有微乳头特征的BOTs是否代表更易复发的侵袭性组织学亚型。
