非上皮性卵巢恶性肿瘤的保留生育功能手术：肿瘤学和生殖结局的十年回顾性研究
Fertility-Sparing Surgery for Non-Epithelial Ovarian Malignancies: Ten-Year Retrospective Study of Oncological and Reproductive Outcomes.
作者信息
Likic Ladjevic Ivana, Dotlic Jelena, Stefanovic Katarina, Milosevic Branislav, Beleslin Aleksandra, Mihaljevic Olga, Bila Jovan, Vukovic Ivana, Radojevic Milos, Vilendecic Zoran
机构信息
Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, Dr Koste Todorovica 26, 11000 Belgrade, Serbia.
Medical Faculty, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia.
出版信息
Cancers (Basel). 2025 Apr 12;17(8):1304. doi: 10.3390/cancers17081304.
BACKGROUND/OBJECTIVES: Due to the rarity and histological heterogeneity of non-epithelial ovarian cancers (NEOCs), monitoring their reproductive and oncological outcomes is challenging. Therefore, this study aimed to investigate the oncological and reproductive outcomes of patients with NEOCs treated with fertility-sparing surgery over the past 10 years at our tertiary referral university clinic.
METHODS
This retrospective study included all the NEOC patients diagnosed and treated with fertility-sparing surgery from 2010 to 2019. The patient demographic and clinical characteristics; data regarding the treatment andthe clinical, laboratory, and imaging findings during follow-up; and disease recurrences were recorded. In this study, the recurrence-free survival and the overall survival were the oncological outcomes. The reproductive outcomes were assessed as attempting and achieving pregnancy.
RESULTS
This study included 39 patients. The most frequent NEOCs were granulosa cell tumors (53.8%). The majority of the tumors were in the IA or IC1 stage. The initial therapy was generally a unilateral salpingo-oophorectomy (30.8%). Adjuvant chemotherapy was received by 48.7% of the patients. An NEOC recurrence was registered in 25.6% of the patients, mostly during the first two postoperative years. The recurrence-free survival was 76.92%. A regression analysis showed that amore advanced stage of NEOC was the most important predictor of disease recurrence. The overall survival rate was 87.2%, with a mean time to an adverse outcome of 23.01 +/-10.68 months. The regression analysis showed that better survival depended mostly on not having disease recurrence. After treatment, ten patients tried to conceive and seven succeeded. All the children were in good condition upon birth.
CONCLUSIONS
Fertility-sparing treatment for NEOCs was proven as a safe and successful option in terms of both oncological and reproductive outcomes.
背景/目的：由于非上皮性卵巢癌（NEOCs）罕见且组织学异质性强，监测其生殖和肿瘤学结局具有挑战性。因此，本研究旨在调查过去10年在我们的三级转诊大学诊所接受保留生育功能手术治疗的NEOC患者的肿瘤学和生殖学结局。
方法
这项回顾性研究纳入了2010年至2019年期间所有诊断为NEOC并接受保留生育功能手术治疗的患者。记录患者的人口统计学和临床特征；治疗数据以及随访期间的临床、实验室和影像学检查结果；以及疾病复发情况。在本研究中，无复发生存期和总生存期为肿瘤学结局。生殖结局评估为尝试妊娠和成功妊娠。
结果
本研究纳入了39例患者。最常见的NEOC是颗粒细胞瘤（53.8%）。大多数肿瘤处于IA期或IC1期。初始治疗通常为单侧输卵管卵巢切除术（30.8%）。48.7%的患者接受了辅助化疗。25.6%的患者出现NEOC复发，大多在术后头两年内。无复发生存率为76.92%。回归分析表明，NEOC分期越晚是疾病复发的最重要预测因素。总生存率为87.2%，不良结局的平均时间为23.01±10.68个月。回归分析表明，更好的生存率主要取决于无疾病复发。治疗后，10例患者尝试受孕，7例成功。所有孩子出生时状况良好。
结论
就肿瘤学和生殖学结局而言，NEOC的保留生育功能治疗被证明是一种安全且成功的选择。
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