Clinical outcome and risk factors for recurrence in borderline ovarian tumours.
Clinical outcome and risk factors for recurrence in borderline ovarian tumours.
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DOI：
10.1038/sj.bjc.6603139
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发表时间：
2006-06-05
影响因子：
8.8
通讯作者：
Mizunuma, H.
中科院分区：
文献类型：
--
作者：
Yokoyama, Y.;Moriya, T.;Takano, T.;Shoji, T.;Takahashi, O.;Nakahara, K.;Yamada, H.;Yaegashi, N.;Okamura, K.;Izutsu, T.;Sugiyama, T.;Tanaka, T.;Kurachi, H.;Sato, A.;Tase, T.;Mizunuma, H.
我们研究了交界性卵巢肿瘤的长期预后，并确定了复发的危险因素。1994年至2003年在东北妇科癌症单位的参与机构治疗的121例交界性卵巢肿瘤的临床分期，组织病理学亚型，手术技术，术后化疗，复发或不复发，预后进行了回顾性研究。中位随访期为57个月（1-126个月）。109例（90.6%）处于临床I期。组织病理学类型为粘液性肿瘤91例（75.2%），浆液性肿瘤27例（22.3%），类浆液性肿瘤3例。保守性手术53例（43.8%），根治性手术68例（56.2%），分期开腹手术43例（35.5%），术后辅助治疗30例（24.8%）。在8例病例中发现复发，但没有报告与肿瘤相关的死亡。不同临床分期间无病生存率差异无统计学意义，但浆液性与非浆液性（黏液性与类黏液性）间无病生存率差异有统计学意义（P<0.05）。根治性手术组10年无瘤生存率为89.1%，保守性手术组为57.4%，差异有统计学意义（P<0.05）。在保守手术组中，囊肿和浆液性肿瘤是复发的独立危险因素。虽然观察到复发，但交界性卵巢肿瘤的长期预后良好，无肿瘤相关死亡。考虑到良好的预后，只要患者为非浆液性肿瘤并接受附件切除术，可选择保守手术。然而，对于浆液性和/或接受环磷酰胺治疗的病例，应给予特别护理，因为复发的相对风险率升高2-4倍。
We investigated the long-term prognosis of borderline ovarian tumours and determined risk factors for recurrence. One hundred and twenty-one borderline ovarian tumours treated between 1994 and 2003 at the participating institutions in the Tohoku Gynecologic Cancer Unit were retrospectively investigated for clinical stage, histopathological subtype, surgical technique, postoperative chemotherapy, the presence or absence of recurrence, and prognosis. The median follow-up period was 57 months (1–126 months). One hundred and nine cases (90.6%) were at clinical stage I. The histopathological subtypes consisted of 91 cases of mucinous tumour (75.2%), 27 cases of serous tumour (22.3%), and three cases of endometrioid tumour. Conservative surgery was used in 53 cases (43.8%), radical surgery in 68 cases (56.2%), a staging laparotomy in 43 cases (35.5%), and postoperative adjuvant therapy in 30 cases (24.8%). Recurrence was found in eight cases, but no tumour-related deaths were reported. Although no significant difference in disease-free survival rate was seen between different clinical stages, the difference in disease-free survival rate between serous and nonserous (mucinous and endometrioid) types was significant (P<0.05). The 10-year disease-free survival rate was 89.1% for the radical surgery group and 57.4% for the conservative surgery group – this difference was significant (P<0.05). In the conservative surgery group, cystectomy and serous tumour were independent risk factors for recurrence. Although recurrence was observed, the long-term prognosis of borderline ovarian tumour was favourable, without tumour-related deaths. Considering the favourable prognosis, conservative surgery can be chosen as far as the patient has a nonserous tumour and receive adnexectomy. However, in cases of serous type and/or receiving cystectomy special care should be given as relative risk rates of recurrence elevate by 2–4-folds.
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影响因子：
7.2
作者：
Winter, WE;Kucera, PR;Maxwell, GL
通讯作者：
Maxwell, GL
影响因子：
7.2
作者：
Morris, RT;Gershenson, DM;Wharton, JT
通讯作者：
Wharton, JT
影响因子：
6.7
作者：
Donnez, J;Munschke, A;Squifflet, J
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Squifflet, J
影响因子：
5.2
作者：
Camatte, S;Morice, P;Castaigne, D
通讯作者：
Castaigne, D
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4.7
作者：
BARAKAT, RR;BENJAMIN, I;HOSKINS, WJ
通讯作者：
HOSKINS, WJ