Safety of conservative management and fertility outcome in women with borderline tumors of the ovary
Safety of conservative management and fertility outcome in women with borderline tumors of the ovary
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DOI：
10.1016/s0015-0282(03)00160-2
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发表时间：
2003-05-01
影响因子：
6.7
通讯作者：
Squifflet, J
中科院分区：
文献类型：
--
作者：
Donnez, J;Munschke, A;Squifflet, J
目的：为了评估生育保留治疗的安全性和手术后生育的剩余机会。设计：回顾性临床研究。设置：一所大学教学医院的妇科。患者：1986年至2001年，75名妇女在我们的机构接受了手术治疗的卵巢交界性肿瘤。干预：59例患者进行了根治性，生育力妥协手术治疗。其余16例患者接受保守手术，保留子宫和至少一些功能性卵巢组织。7例单侧附件切除术，1例单纯囊肿切除术，2例附件切除术合并对侧囊肿切除术。主要结果测量：复发率、生存率和妊娠率。结果：根治性和保守性手术后观察到的复发率分别为0.0%和18.7%。任何组均未发生疾病相关死亡;存活率无显著差异。我们可以报告12怀孕7 I I妇女谁进行生育保留管理，谁希望成为pregnancy. Conclusions（S）：在某些情况下，保守的管理提供了一个安全的解决方案，卵巢交界性肿瘤。在这种类型的治疗后，复发率明显更高，但所有复发性疾病的病例都可以通过密切随访发现并进行相应的治疗。存活率无明显变化，而保守治疗的妊娠率高达63.6%。(C)2003年，美国生殖医学会。
Objective: To assess the safety of fertility-sparing treatment and the remaining chance of childbearing after surgery.Design: Retrospective clinical study.Setting: Gynecology department of a university teaching hospital.Patient(s): Seventy-five women underwent surgical management in our institution between 1986 and 2001 for borderline tumors of the ovary.Intervention(s): Fifty-nine patients were treated by radical, fertility-compromising surgery. The remaining 16 patients underwent conservative surgery, preserving the uterus and at least some functional ovarian tissue. Seven unilateral adnexectomies, one simple cystectomy, and two adnexectomies associated with contralateral cystectomy were performed.Main Outcome Measure(s): Recurrence, survival, and pregnancy rates.Result(s): The observed recurrence rates after radical and conservative surgery were 0.0% and 18.7%, respectively. No disease-related deaths occurred in any group; there is no significant difference in survival rates. We can report 12 pregnancies in 7 of I I women who underwent fertility-sparing management and who wished to become pregnant.Conclusion(s): In certain circumstances, conservative management offers a safe solution for borderline tumors of the ovary. Recurrence is noted significantly more often after this type of treatment, but all cases of recurrent disease can be detected with close follow-up and can be treated accordingly. No significant change in survival rates was found. Moreover, the pregnancy rate in women desiring pregnancy, those treated conservatively, was as high as 63.6%. (C) 2003 by American Society for Reproductive Medicine.