| Background:Ovarian borderline tumor is a special type of ovarian tuor whose biological behavior is between benign and alignant.At present,there is no standard guideline to specify the treatent plan.Its diagnosis is mainly based on the pathological results,the main treatent is surgery,the operation plan is mainly decided according to the wishes of the patient and her family in cobination with the patient’s condition,and there are no uniform rules.It is of great significance for clinicians to study the influence of different factors on postoperative recurrence of ovarian tumor patients.Objective:It is hoped that it can help clinicians to select appropriate treatment regimens for patients with borderline ovarian tumors,so as to improve the postoperative quality of life and prognosis of patients on the premise of reducing recurrence rate.ethods:Patients with borderline ovarian tumors diagnosed by pathology after surgery in our hospital(The second hospital of JiLin university)from April 2011 to April 2019 were selected.Basic information and diagnosis and treatment history of the patients were inquired through the case system of our hospital,and the prognosis of the patients was followed up for retrospective analysis.Chi-square test and logistic regression were used for statistical analysis.Results:1.The onset age of the patients ranged from 12 years old to 50 years old,with an average age of 32.2±9.9 years.2.The tumors involved bilateral ovaries in 13 patients and recurred in 5 patients(38.5%).Unilateral ovarian involved in 85 patients,6(7.1%)recurrence.There was a statistically significant difference between unilateral and bilateral ovarian tumor involvement(P=0.004).3.There were 48 patients with maximum tumor diameter< 10 cm,and 5 patients(10.4%)had recurrence.The largest diameter of tumor≥10cm was found in 50 patients,and 6 patients(12%)had recurrence.There was no statistically significant difference in tumor size in tumor recurrence(P=0.804).4.58 patients were anechoic and 3 patients(5.2%)had recurrence.Of the 29 hypoechoic patients,3(10.3%)had recurrence.There was no statistically significant difference in the recurrence rate between the two ultrasound(P=0.376).5.Tumor marker inforation was lost in 26 patients,among theremaining 72 patients,26 were CA125-positive(CA125 normal 0 to 35),2(7.7%)relapsed,46(10.9%)were negative,and 5(10.9%)relapsed.23 patients with CA199 were positive,CA199 normal 0 to 40,2(8.7%)relapsed,49(negative)and 5(10.2%)relapsed.Only 18 patients were tested for HE4,1 positive,(HE4 normal 0 to 140)no recurrence,17 negative,3(17.6%)recurrence.There was no significant difference between CA125(P=0.982),CA199(P=1)and HE4(P=1)in tumor recurrence.6.81 patients was in FIGO stage I,6(7.4%)recurrence,11 patients was in FIGO stage II,3(27.3%)recurrence,6 patients was in FIGO stage III,2(33.3%)recurrence.The difference of tumor stage in tumor recurrence was statistically significant(P=0.031).7.58 patients had borderline pathology after surgery,4(6.9%)relapsed.31 borderline serous cases,6(19.4%)elapsed,and other types in 9 patients.There was no statistically significant difference in tumor recurrence between the two most common pathological types(P=0.155).8.In 62 patients undergoing open surgery,5(8.1%)had recurrence,while in 36 patients undergoing laparoscopic surgery,6(16.7%)had recurrence.There was no significant difference in the surgical route in tumor recurrence(P=0.193).9.There were no recurrence in 26 patients undergoing radical surgery,72 patients undergoing conservative surgery and 11 patients(15.3%)with recurrence.Among them,42 patients had tumor resection,10 patients(23.8%)had recurrence,30 patients underwent unilateral addendum resection,and 1(3.3%)relapsed.There was a statistically significant difference in tumor recurrence between radical surgery and conservative surgery(P=0.034).In conservative surgery,there was a statistically significant difference in tumor recurrence between tumor stripping and excision.(P=0.04).10.Only 4 patients underwent postoperative chemotherapy,and 2(50%)relapsed.There was no statistically significant difference in tumor recurrence with or without chemotherapy(P=0.089).11.Among the 11 patients with recurrence in this group,only 1 had the pathological result of recurrence and developed into local intraepithelial carcinoma.As the patient was 14 years old,it was strongly required to undergo fertility preservation surgery again.No recurrence was found in the current dynaic observation.The postoperative pathology of the remaining 10 patients was the same as initial pathology.Among them,9 patients underwent conservative surgery again,and 1 patient was older and had no fertility preservation and endocrine requirements,so he underwent radical surgery.During follow-up,no recurrence was observed in all patients.Conclusion:1.FIGO staging,bilateral ovarian involvement,surgicalprotocol(conservative and radical treatment),and surgical scope(addendum resection and tumor exfoliation)may be related to postoperative recurrence of ovarian borderline tumor.2.FIGO staging and bilateral ovarian involvement may be independent risk factors for tumor recurrence.3.Laparoscopy and laparotomy had no significant effect on postoperative tumor recurrence.For patients with small tumor size and no history of pelvic surgery,laparoscopy was preferred.4.For the patients with fertility or endocrine requirements,conservative surgery is feasible,but regular follow-up is required.Compared with the removal of ovarian tumor,adjunctive resection can reduce the recurrence rate to a certain extent.5.Most of the postoperative recurrence of BOT is still BOT,and conservative surgery can still be performed again,but close follow-up is required.6.Postoperative adjuvant chemotherapy has no obvious effect on reducing postoperative recurrence rate. |
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