Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Int J Gynaecol Obstet. 2024 Jun;165(3):1229-1236. doi: 10.1002/ijgo.15338. Epub 2024 Jan 11.
To describe the risk of women who have survived borderline ovarian tumors (BOT) developing second primary malignancies (SPM).
This work employed the Surveillance, Epidemiology, and End Results (SEER) Program to conduct a retrospective study of patients diagnosed with BOT. The SEER stat software was used to calculate the standardized incidence ratio (SIR). Cases with pathologic diagnosis and for which information on prognostic factors were available were obtained and analyzed using the Fine and Gray model, with non-SPM death as a competing event.
The risk of developing SPM among BOT survivors was not elevated compared with that expected in the general population (SIR 0.88, 95% confidence interval [CI] 0.80-0.96) between 1975 and 2017. Of 3661 patients with BOT diagnosed between 1977 and 2000, 477 patients (13.03%) experienced the development of SPM during the median follow up of 19.43 years and the cumulative incidence of SPM over a span of 25 years was 15.52%. Patients with mucinous BOT (P = 0.028), age older than 50 years (P < 0.001), or no lymph node dissection (P = 0.042), had a higher cumulative incidence of SPM in univariate analysis. In the multivariable competing risk analysis, performing lymphadenectomy (subdistribution hazard ratios [sdHR] 0.79, 95% CI 0.64-0.98), age (sdHR 1.03, 95% CI 1.02-1.03) could strongly predict the risk of SPM.
In contrast to ovarian cancer, women with BOT were not more prone to develop SPM.
描述患有交界性卵巢肿瘤(BOT)的女性发生第二原发恶性肿瘤(SPM)的风险。
本研究利用监测、流行病学和最终结果(SEER)计划对诊断为 BOT 的患者进行回顾性研究。使用 SEER*Stat 软件计算标准化发病比(SIR)。获取并分析具有病理诊断且预后因素信息可用的病例,使用 Fine 和 Gray 模型,将非 SPM 死亡作为竞争事件。
1975 年至 2017 年间,BOT 幸存者发生 SPM 的风险与普通人群预期的风险相比并未升高(SIR 0.88,95%置信区间 [CI] 0.80-0.96)。在 1977 年至 2000 年期间诊断出的 3661 名 BOT 患者中,有 477 名(13.03%)在中位随访 19.43 年期间发生了 SPM,并且在 25 年内 SPM 的累积发生率为 15.52%。在单变量分析中,黏液性 BOT 患者(P=0.028)、年龄大于 50 岁(P<0.001)或未行淋巴结清扫术(P=0.042)的患者 SPM 累积发生率更高。在多变量竞争风险分析中,行淋巴结清扫术(亚分布危险比 [sdHR] 0.79,95%CI 0.64-0.98)、年龄(sdHR 1.03,95%CI 1.02-1.03)可以强烈预测 SPM 的风险。
与卵巢癌不同,患有 BOT 的女性发生 SPM 的风险并不更高。