Department of Surgery, MS 133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
Department of Surgery, MS 133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
Eur J Surg Oncol. 2023 Oct;49(10):106923. doi: 10.1016/j.ejso.2023.04.022. Epub 2023 May 18.
An increased number of children and adolescents with ovarian tumors have been managed with ovarian-sparing surgery in the last few years. However, comprehensive data on fertility outcomes and local relapse are scarce. In this study, we systematically describe the contemporary outcomes of ovarian-sparing surgery, as reported in the literature.
Using PRISMA guidelines, we analyzed studies reporting ovarian-sparing techniques for ovarian tumors in children and adolescents. from 1980 to 2022. Reports with fewer than three patients, narrative reviews, and opinion articles were excluded. Statistical analysis was performed for dichotomous and continuous variables.
Of 283 articles screened, 16 papers (3057 patients) met inclusion criteria (15 retrospective/1 prospective) and were analyzed. The vast majority of studies had no long-term fertility follow-up data and direct comparison between ovarian-sparing surgery vs oophorectomy was reported in only a few studies. Ovarian sparing surgery was not associated with worse oncologic outcomes in terms of (i) tumour spillage or (ii) recurrence rates, and of key importance allowed a higher ovarian reserve at long term follow-up.
Ovarian-sparing surgery is a safe and feasible technique for benign tumors. Long-term outcome studies are needed to show efficacy and fertility preservation.
近年来，越来越多的儿童和青少年卵巢肿瘤患者接受了保留卵巢手术。然而，关于生育结局和局部复发的综合数据仍然缺乏。在这项研究中，我们系统地描述了文献中报道的保留卵巢手术的当代结果。
我们使用 PRISMA 指南，分析了 1980 年至 2022 年期间报道儿童和青少年卵巢肿瘤保留卵巢技术的研究。排除了少于 3 例患者的报告、叙述性综述和观点文章。对二项和连续变量进行了统计分析。
在筛选出的 283 篇文章中，有 16 篇论文（3057 例患者）符合纳入标准（15 篇回顾性/1 篇前瞻性）并进行了分析。大多数研究没有长期的生育随访数据，只有少数研究报告了保留卵巢手术与卵巢切除术之间的直接比较。保留卵巢手术在肿瘤播散或（ii）复发率方面与更好的肿瘤学结果无关，并且更重要的是在长期随访中保留了更高的卵巢储备。
保留卵巢手术是治疗良性肿瘤的一种安全可行的技术。需要进行长期的结局研究来显示其疗效和生育保护。
