摘要
目的:探讨卵巢交界性肿瘤(BOTs)患者手术治疗后影响复发率及妊娠结局的相关因素。方法:收集郑州大学第三附属医院2010年3月至2018年12月手术治疗的96例BOTs患者的病例资料及随访结果,行回顾性统计学分析。结果:单因素分析显示患者术前CA199水平、手术途径、手术范围、肿瘤直径、国际妇产科联盟(FIGO)分期与BOTs手术治疗后复发有关(P<0.05),但多因素Logistic回归分析结果显示以上因素均不是肿瘤复发的独立危险因素。保守性手术组的手术时间、术中失血量均低于根治性手术组(P<0.05),且复发率高于根治性手术组(16.1%vs 0,P<0.05)。根治性手术组、单侧附件切除术组及肿瘤剥除术组3组术后复发率分别为0、12.5%、18.2%,差异有统计学意义(P<0.05)。腹腔镜组患者的无瘤生存期(DFS)明显高于开腹组(63.7月vs 50.9月),复发率低于开腹组(4.6%vs 25.6%),差异有统计学意义(P<0.05)。在保留生育功能患者中,15例(39.4%)患者成功妊娠,但肿瘤剥除术组与单侧附件切除术组之间以及腹腔镜手术组与开腹手术组之间妊娠率差异无统计学意义(P>0.05)。结论:术前CA199水平、FIGO分期、肿瘤直径及手术途径、手术范围可能与BOTs术后复发有关,但均不是肿瘤复发的独立危险因素。相对于保守性手术,根治性手术的患者的术后复发率更低,但对于有生育需求的年轻患者可行保留生育能力手术,但术后需严密随访。
Objective:To explore the related factors of recurrence rate and pregnancy outcome in patients with borderline ovarian tumors(BOTs)after surgical treatment.Methods:A total of 96 patients with ovarian borderline tumors who underwent surgery in The Third Affiliated Hospital of Zhengzhou University from March 2010 to December 2018 were enrolled and all of the clinical and follow-up data were retrospectively reviewed.Results:Univariate analysis revealed that preoperative CA199 level,operation route,operation scope,diameter of tumor,and pathological stage of FIGO were related to the recurrence after operation(P<0.05).However,multivariate Logistic regression analysis showed that the above factors were not independent risk factors for tumor recurrence.The operation time and blood loss in conservative operation group were lower than those in radical operation group(P<0.05),and the recurrence rate was higher than that in radical operation group(16.1%vs 0,P<0.05).The recurrence rates after operation in radical operation group,unilateral appendectomy group and cystectomy group were 0,12.5%and 18.2%,respectively.There was significantly statistical difference(P<0.05).The disease free survival(DFS)time in the laparoscopic group was significantly higher than that in the laparotomy group(63.7 months vs 50.9 months),and the recurrence rate was lower than that in laparotomy group(4.6%vs 25.6%)(P<0.05).Among the patients with preservation fertility,15(39.4%)patients had successful pregnancy.However,there was no significant difference in subsequent pregnancy rate between the cystectomy group and the unilateral appendectomy group,and between the laparoscopy group and the laparotomy group(P>0.05).Conclusions:The level of CA199 before operation,FIGO stage,tumor diameter,operation route and operation scope may be related to the recurrence of BOTs after operation,but they are not independent risk factors of tumor recurrence.Compared with conservative surgery,the recurrence rate of patients with radical surgery is lower,but for young patients with fertility desire,preservation fertility surgery is feasible,but strict follow-up is required.
作者
魏心怡
任琛琛
杨立
陈雁南
朱远航
刘泇希
王朝昕
WEI Xinyi;REN Chenchen;YANG Li(Department of Obstetrics and Gynecology,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450052,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2020年第2期119-123,共5页
Journal of Practical Obstetrics and Gynecology
基金
河南省科技攻关项目(编号:162102310131)
关键词
卵巢交界性肿瘤
手术治疗
复发
妊娠结局
Borderline ovarian tumors
Surgicaltreatment
Recurrence
Pregnancy outcomes
