Cang Wei, Liang Chao, Wang Dan, Xue Xiaowei, Cao Dongyan, Yang Jiaxin, Pan Lingya, Wu Ming, Yang Junjun, Xiang Yang
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing 100730, China.
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.
J Clin Med. 2023 Sep 7;12(18):5827. doi: 10.3390/jcm12185827.
Our study aimed to analyze the prognosis and reproductive outcomes of patients with advanced-stage serous borderline ovarian tumors (SBOTs) who underwent fertility-sparing surgery (FSS). This study included patients aged ≤ 45 years diagnosed with advanced-stage (International Federation of Gynecology and Obstetrics II and III) SBOTs who were treated with FSS. Conservative surgeries were performed in 65 patients with advanced-stage SBOT with a median age of 28 years (range, 16-44 years). Nine patients had invasive implants. The median follow-up was 81.7 months. Forty-six patients (70.8%) had a relapse (median time to first recurrence, 22.8 months). Thirteen patients subsequently developed recurrence as an invasive disease, and two died due to disease progression. After multivariate analysis, age < 30 years and incomplete cytoreduction were independent risk factors for recurrence. Invasive implants and postoperative residual tumors were significantly associated with shorter disease-free survival. Of 35 patients attempting to conceive, 12 underwent assisted reproductive technology. Additionally, 19 pregnancies, including 15 full-term births, were documented. FSS provides a good chance of reproductive success in women with advanced-stage SBOT who desire fertility preservation, but it has a high recurrence rate and risk of malignancy transformation. Patients with invasive implants should be strictly selected for FSS.
我们的研究旨在分析接受保留生育功能手术（FSS）的晚期浆液性交界性卵巢肿瘤（SBOT）患者的预后和生殖结局。本研究纳入了年龄≤45岁、诊断为晚期（国际妇产科联盟II期和III期）SBOT且接受FSS治疗的患者。对65例晚期SBOT患者进行了保守手术，患者中位年龄为28岁（范围16 - 44岁）。9例患者有浸润性种植灶。中位随访时间为81.7个月。46例患者（70.8%）复发（首次复发的中位时间为22.8个月）。13例患者随后复发为浸润性疾病，2例因疾病进展死亡。多因素分析后，年龄<30岁和细胞减灭术不完全是复发的独立危险因素。浸润性种植灶和术后残留肿瘤与无病生存期缩短显著相关。在35例尝试受孕的患者中，12例接受了辅助生殖技术。此外，记录了19次妊娠，包括15次足月分娩。对于希望保留生育功能的晚期SBOT女性，FSS提供了良好的生殖成功机会，但复发率高且有恶性转化风险。对于有浸润性种植灶的患者，应严格选择进行FSS。
