Management of borderline ovarian tumours during pregnancy: Results of a French multi-centre study
Management of borderline ovarian tumours during pregnancy: Results of a French multi-centre study
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DOI：
10.1016/j.ejogrb.2020.11.033
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发表时间：
2021-01-01
影响因子：
2.6
通讯作者：
Akladios, C.
中科院分区：
文献类型：
--
作者：
Zilliox, M.;Lecointre, L.;Akladios, C.
目的：探讨妊娠期卵巢交界性肿瘤(BOT)的诊断和预后特点，并建立一份法国临床实践目录。材料和方法：对2005年至2017年在法国5个盆腔肿瘤专家中心接受BOT治疗的14例患者进行多中心回顾性病例研究，包括临床特征、组织学肿瘤特征、手术操作、辅助治疗、随访和生育情况。结果：患者的平均年龄为29.3[标准差(SD)6.2]岁。大多数机器人是在怀孕早期(85.7%)通过超声诊断出来的，这些病例中的大多数(78.5%)还接受了磁共振成像来确认诊断(真阳性占54.5%)。大多数患者在妊娠期接受了手术(57%)，其中2例(14.3%)接受了完全分期手术。腹腔镜术比其他手术更常见(50%)，单侧附件切除术比膀胱切除术更常见(57.5%)。肿瘤大小对手术入路有显著影响(腹腔镜组平均7.5 cm，中转开腹组11.9 cm，初次开腹组14 cm，P=0.08)，而肿瘤切除类型无显著差异。大多数患者最初被诊断为国际妇产科联合会IA期肿瘤(92.8%)，但许多患者在完全再分期手术后被抢了风头(57.1%)。大多数机器人是浆液性的(50%)，2例有微乳头成分(28.5%)，1例有微创植入物。2例(14.2%)为双侧BOT。平均随访31.4(SD 14.8)个月。两名患者(14.2%)发生了复发的病变，到目前为止在研究人群中还没有记录到死亡。结论：机器人仍然很少见，但这项研究-尽管样本量很小-支持了机器人在怀孕期间具有潜在攻击性特征的假设。(C)2020爱思唯尔B.V.保留所有权利。
Objective: To assess the diagnostic and prognostic characteristics of borderline ovarian tumours (BOTs) detected during pregnancy, and to establish an inventory of French practices.Materials and methods: A retrospective multi-centre case study of 14 patients treated for BOTs, diagnosed during pregnancy between 2005 and 2017, in five French pelvic cancerology expert centres, including data on clinical characteristics, histological tumour characteristics, surgical procedure, adjuvant treatments, follow-up and fertility.Results: The mean age of patients was 29.3 [standard deviation (SD) 6.2] years. Most BOTs were diagnosed on ultrasonography in the first trimester (85.7 %), and most of these cases (78.5 %) also underwent magnetic resonance imaging to confirm the diagnosis (true positives 54.5 %). Most patients underwent surgery during pregnancy (57 %), with complete staging surgery in two cases (14.3 %). Laparoscopy was performed more frequently than other procedures (50 %), and unilateral adnexectomy was more common than cystectomy (57.5 %). Tumour size influenced the surgical approach significantly (mean size 7.5 cm for laparoscopy, 11.9 cm for laparoconversion, 14 cm for primary laparotomy; P = 0.08), but the type of resection did not. Most patients were initially diagnosed with International Federation of Gynecology and Obstetrics stage IA (92.8 %) tumours, but many were upstaged after complete restaging surgery (57.1 %). Most BOTs were serous (50 %), two cases had a micropapillary component (28.5 %), and one case had a micro-invasive implant. BOTs were bilateral in two cases (14.2 %). Mean follow-up was 31.4 (SD 14.8) months. Recurrent lesions occurred in two patients (14.2 %) and no deaths have been recorded to date among the study population.Conclusion: BOTs remain rare, but this study - despite its small sample size - supports the hypothesis that BOTs during pregnancy have potentially aggressive characteristics. (C) 2020 Elsevier B.V. All rights reserved.