| Object:The clinical characteristics of Borderline Ovarian Tumors(BOTs)were summarized and the risk factors related to recurrence were discussed by retrospective analysis of the general characteristics,preoperative examination data,surgical data,postoperative conditions and follow-up data of the patients.Materials and Methods:A total of 268 patients who were pathologically diagnosed as BOTs underwent surgical treatment in our hospital from June 2012 to June 2021 were collected and analyzed.Preoperative general characteristics(age,family history of malignancy,occupation,number of pregnancy,with mammary gland and thyroid disease),preoperative examination,inspection data(three dimensional ultrasound imaging,tumor marker levels),recording operation,postoperative and follow-up data information were recorded and analyzed since the end of treatment to February 2022,discussing relevant risk factors that may influence patient relapse.SPSS 26.0 software was used for statistical analysis,and t test,x2 test,rank sum test and other tests were used to compare the clinical and pathological factors between the survival-free group and the recurrence group.The disease-free survival time was calculated by Kaplan-Meier method,and log-rank test was used for survival analysis.The factors with statistical distribution difference and clinical significance were included in Cox proportional risk model for multivariate analysis.P<0.05 considered that the difference was statistically significant.Results:1.Through the analysis of patients with preoperative general characteristics(age,family history of malignancy,occupation,number of pregnancy,with breast diseases and thyroid diseases),preoperative three-dimensional ultrasound imaging findings(nature of the tumor,clear boundary and the surrounding tissue and tumor blood supply situation,the internal space,whether there is "papillary tumor""cauliflower-like "bump,with basin peritoneal effusion),preoperative distribution of tumor markers(HE4,CA199,CA125,CEA and AFP),it was found that the age of BOTs patients was mostly under 40 years old(69.0%),three-dimensional ultrasound manifestations were common as followed:cystic or cystic solid(94.8%),boundary is still clear(49.7%),"dotted line" blood flow signal(57.1%),and FIGO stage was mostly stage I(76.9%).2.HE4 and AFP levels were negative in all patients after recurrence,with only 3 patients(9.4%)positive for CA199,14 patients(43.8%)positive for CA125 and 4 patients(12.5%)positive for CEA.According to the recurrence during the follow-up period,the patients were divided into the survival-free group and the recurrence group.After the difference analysis of preoperative general characteristics,preoperative examination,surgical data,postoperative pathology and adjuvant therapy and other factors,it was found that the distribution of postoperative FIGO stage was different between the two groups(P=0.002),and there was no statistically significant difference in the distribution of other factors between the two groups.3.Surgical method and FIGO stage were independent risk factors affecting the time to disease-free survival.Patients undergoing incomplete stage surgery had an increased risk of recurrence compared with patients undergoing full stage surgery(P=0.023).FIGO stage Ⅱ patients compared with stage Ⅰ patients(P=0.002),patients with stage Ⅲ and above compared with stage Ⅰ patients(P=0.025)had an increased risk of recurrence,and patients with higher stage had an increased risk of recurrence.Conclusion:1.Surgical methods and tumor FIGO stage were independent risk factors affecting the disease-free survival of BOTs patients.Patients who underwent comprehensive staging surgery and earlier tumor stage had longer disease-free survival and lower risk of recurrence;2.Recurrence is possible even if tumor markers are negative during postoperative follow-up;CA125 plays an important role in the follow-up after treatment. |
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