Outcome and reproductive function after conservative surgery for borderline ovarian tumors
Outcome and reproductive function after conservative surgery for borderline ovarian tumors
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DOI：
10.1016/s0029-7844(99)00619-5
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发表时间：
2000-04-01
影响因子：
7.2
通讯作者：
Wharton, JT
中科院分区：
文献类型：
--
作者：
Morris, RT;Gershenson, DM;Wharton, JT
目的：研究卵巢交界性肿瘤保守手术患者的生殖功能和疾病转归。如果患者有病理证实的交界性卵巢肿瘤，没有事先绝育，没有放射治疗史，保留了子宫和卵巢组织，并且年龄在45岁以下，就符合条件。通过回顾病历和患者访谈获得信息。结果：43例患者符合资格标准。年龄中位数为25岁，范围为15-39岁。26例为浆液性肿瘤，17例为粘液性肿瘤。15例为I期，3例为III期，25例未分期。所有患者均获得随访(中位数为5.7年)。29例保持无病，14例出现新的原发病变/复发，中位复发时间为39.3个月。卵巢囊肿切除术者的复发率高于单纯卵巢摘除术者(58%比23%)(P<；.04)。治疗后，36名患者中有29名(81%)保持了正常的月经周期，24名试图怀孕的患者中有12名怀孕了25次。大多数患者对保守手术非常满意。结论：对于部分卵巢交界性肿瘤患者，保守手术仍是一种治疗选择。虽然新的病变/复发率相对较高，特别是在那些接受卵巢膀胱切除术的患者中，但癌症的死亡率仍然很低。许多希望怀孕的患者能够在保守手术后怀孕并生下健康的后代。(C)2000年，由美国妇产科医师学会提供。
Objective: To study reproductive function and disease outcome in women with borderline ovarian tumors who were treated with conservative surgery.Methods: Patients with borderline ovarian tumors were identified from institutional databases. Patients were eligible if they had pathologically confirmed borderline ovarian tumors, no prior sterilization, no history of radiation therapy, retained their uterus and ovarian tissue, and were younger than age 45. Information was acquired by retrospective medical record review and patient interview.Results: Forty-three patients met the eligibility criteria. The median age was 25 years, with a range of 15-39 years. Twenty-six patients had serous tumors, and 17 had mucinous tumors. Fifteen had stage I disease, three had stage III, and 25 were unstaged. Follow-up was available for all patients (median, 5.7 years). Twenty-nine remained disease-free, and 14 developed a new primary lesion/recurrence, with a median time to recurrence of 39.3 months. Recurrence was more frequent in patients treated with ovarian cystectomy than in those treated with oophorectomy alone (58% compared with 23%) (P < .04). After treatment, 29 of 36 patients (81%) retained normal menstrual cycles, and 12 of 24 patients attempting pregnancy conceived 25 pregnancies. Most patients were highly satisfied with conservative surgery.Conclusion: Conservative surgery remains a therapeutic option in selected patients with borderline ovarian tumors. Although the rate of new lesion/recurrence is relatively high, especially in those treated with ovarian cystectomy, mortality from cancer remains low. Many patients who desire pregnancy are able to conceive and deliver healthy offspring after conservative surgery. (C) 2000 by The American College of Obstetricians and Gynecologists.