Oncofertility in patients with stage I epithelial ovarian cancer: fertility-sparing surgery in young women of reproductive age.
Oncofertility in patients with stage I epithelial ovarian cancer: fertility-sparing surgery in young women of reproductive age.
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I 期上皮性卵巢癌患者的肿瘤生育能力：年轻育龄女性的生育力保留手术
DOI：
10.1186/s12957-017-1222-4
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发表时间：
2017-08-15
影响因子：
3.2
通讯作者：
Shen K
中科院分区：
文献类型：
--
作者：
Jiang X;Yang J;Yu M;Xie W;Cao D;Wu M;Pan L;Huang H;You Y;Shen K
保留生育能力的手术适用于I期上皮性卵巢癌患者。我们试图评估一组育龄期上皮性卵巢癌（EOC）患者的临床结果和肿瘤生育能力。本研究共纳入1999 - 2013年间在北京协和医院就诊的108例育龄（≤40岁）期EOC患者。生存率分析采用Kaplan-Meier模型和Cox回归分析。手术类型包括保生育手术（FSS）（48.1%）和根治性手术（RS）（51.9%）。在中位随访83个月后，我们观察到在多变量分析中，3级或透明细胞癌是无病生存和肿瘤特异性生存的唯一独立危险因素。3级或透明细胞癌患者倾向于年龄大于30岁，有子宫内膜异位症，并接受RS （p < 0.05）。保留生育能力的手术对育龄期I期EOC患者和IC2-3期、3级或透明细胞癌高危患者的无病生存或肿瘤特异性生存没有影响。52名FSS患者中有34人（65.4%）试图怀孕。28例（82.4%）成功妊娠足月分娩。3级或透明细胞癌是育龄I期EOC患者生存的唯一独立危险因素。FSS可以安全地用于1-2级I期EOC的育龄患者。FSS治疗3级和透明细胞癌的安全性有待进一步研究。
Fertility-sparing surgery is indicated for patients with stage I epithelial ovarian cancers. We sought to evaluate the clinical outcomes and oncofertility in a cohort of patients of reproductive age with stage I epithelial ovarian cancer (EOC). Overall, 108 patients of reproductive age (≤ 40 years) diagnosed with stage I EOC who were treated at Peking Union Medical College Hospital between 1999 and 2013 were included in the study. The Kaplan-Meier model and Cox regression analyses were used for the survival analysis. The type of surgery included fertility-sparing surgery (FSS) (48.1%) and radical surgery (RS) (51.9%). After a median follow-up of 83 months, we observed that grade 3 or clear-cell carcinoma was the only independent risk factor for disease-free survival and tumor-specific survival in the multivariate analysis. Patients with grade 3 or clear-cell carcinoma tended to be older than 30 years, have endometriosis, and undergo RS (p < 0.05). Fertility-sparing surgery did not affect disease-free survival or tumor-specific survival among patients of reproductive age with stage I EOC and among high-risk patients with stage IC2-3, grade 3, or clear-cell carcinoma. Thirty-four out of 52 (65.4%) FSS patients attempted to get pregnant. Twenty-eight (82.4%) achieved a successful pregnancy with a full-term delivery. Grade 3 or clear-cell carcinoma was the only independent risk factor for survival of patients of reproductive age with stage I EOC. FSS can be safely performed on patients of reproductive age with grade 1-2, stage I EOC. The safety of FSS for grade 3 and clear-cell carcinoma warrants further investigation.
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影响因子：
3.3
作者：
Kajiyama, Hiroaki;Mizuno, Mika;Kikkawa, Fumitaka
通讯作者：
Kikkawa, Fumitaka
影响因子：
50.5
作者：
Fruscio, R.;Corso, S.;Colombo, N.
通讯作者：
Colombo, N.
影响因子：
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作者：
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影响因子：
6.7
作者：
Ye, Shuang;Yang, Jiaxin;Shen, Keng
通讯作者：
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影响因子：
3.7
作者：
Marpeau, Olivier;Schilder, Jeanne;Morice, Philippe
通讯作者：
Morice, Philippe