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孤立性或偶发性浆液性输卵管上皮内癌的临床结局及治疗模式:一项多中心回顾性队列研究

Clinical outcome and pattern of care for isolated or incidental serous tubal intraepithelial carcinoma: a multicenter retrospective cohort study.

作者信息

Kim Bo Ra, Kim Se Ik, Kim Sang Wun, Choi Chel Hun, Lee Shin-Wha, Lim Myong Cheol, Kim Yun Hwan

机构信息

Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Seoul, Korea.

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Gynecol Oncol. 2025 Sep;36(5):e68. doi: 10.3802/jgo.2025.36.e68. Epub 2025 Feb 11.

Abstract

OBJECTIVE

Serous tubal intraepithelial carcinoma (STIC), a potential precursor of high-grade serous carcinoma, is associated with subsequent carcinomas development. This study aimed to identify cases of STIC and serous tubal intraepithelial lesions (STIL) and examine clinical outcomes and patterns of care in mutations carriers undergoing risk-reducing salpingo-oophorectomy (RRSO), as well as patients with incidental STIC/STIL after benign gynecologic surgery.

METHODS

This retrospective study was conducted at six institutions to examine patients with isolated STIC/STIL. Demographic, adjuvant treatment, and follow-up data were collected from the date of implementation of Sectioning and Extensively Examining the Fimbriated end protocol, which varied from 2006 to 2015, until December 2022.

RESULTS

We analyzed the data of 1,119 women who underwent RRSO and were carriers of mutations. The detection rate of isolated STIC/STIL was 1.70%. No patient with STIC/STIL received adjuvant chemotherapy or staging operations. The institutions used different surveillance intervals and methods, with the most common being a 3-6 month interval (11 of 19 patients) and gynecological sonography (17 of 19 patients). All patients remained with no evidence of disease (NED) throughout the follow-up period (2-121 months). Additionally, we analyzed data from five women with incidental STIC/STIL diagnosed after benign gynecological surgery; one woman underwent staging surgery. During the follow-up period (3-46 months), all patients remained in NED.

CONCLUSION

While patient monitoring after STIC/STIL detection may be considered due to the minimal risk of carcinoma, excessive concern may not be necessary. Furthermore, adjuvant chemotherapy should be considered only with caution.

摘要

目的

浆液性输卵管上皮内癌(STIC)是高级别浆液性癌的潜在前体,与后续癌症发展相关。本研究旨在识别STIC和浆液性输卵管上皮内病变(STIL)病例,并检查接受降低风险的输卵管卵巢切除术(RRSO)的突变携带者以及良性妇科手术后偶然发现STIC/STIL的患者的临床结局和护理模式。

方法

这项回顾性研究在六个机构进行,以检查孤立性STIC/STIL患者。从2006年至2015年实施的输卵管伞端切片和广泛检查方案开始,直至2022年12月,收集人口统计学、辅助治疗和随访数据。

结果

我们分析了1119名接受RRSO且为突变携带者的女性的数据。孤立性STIC/STIL的检出率为1.70%。没有STIC/STIL患者接受辅助化疗或分期手术。各机构使用不同的监测间隔和方法,最常见的是3 - 6个月的间隔(19名患者中的11名)和妇科超声检查(19名患者中的17名)。在整个随访期(2 - 121个月),所有患者均无疾病证据(NED)。此外,我们分析了五名良性妇科手术后偶然诊断为STIC/STIL的女性的数据;一名女性接受了分期手术。在随访期(3 - 46个月),所有患者均保持NED状态。

结论

虽然由于癌症风险极小,STIC/STIL检测后可考虑对患者进行监测,但可能无需过度担忧。此外,辅助化疗应谨慎考虑。

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