| Objective:To investigate the clinical features and pathological features of BOTs.To provide suggestions for surgical pathways of fertility-sparing operationg.To select the most beneficial pathway for fertility preservation therapy by analysing fertility rate and recurrence rate retrospectively.And to provide better proofs for clinical judgements for boderline ovarian tumor for gynecological tumor doctors.Methods:We select 110 cases of borderline ovarian tumor patients in Qilu Hospital of Shandong University.All of them were treated with conservative therapy.Time span is from December 2005 to December 2015 for 10 years in total.We analyse the information of their operation and chemotherapy.We acquire the information of the fertility and the recurrence mainly through outpatient review and telephone follow-up.The end date of follow-up is December 2016.Use the software SPSS 23.0 to analysis the acquired data.Results:1.Most borderline ovarian tumors were found by health check-ups,more than 50%of the patients showed no obvious clinical manifestations.Some were diagnosed with nausea,vomiting,abdominal pain,abdominal distension or other gynecological problems.2.110 cases of borderline ovarian tumors patients were analysed in total.The age of the patients ranged from 20 to 40 years(mean 29.2±5.2 years).61 serous tumors and 44 mucinous tumors were identified.Another 5 cases of other pathological type were identified(endometrioid,sero-mucinous and Brenner's tumors).One hundrud and five tumors(95.5%)were stage ?,of which 72 were stage ?a,10 stage ?b and 23 stage Ic because of surface involvement,rupture,positive peritoneal washings,or combinations of these findings.Five tumors(4.5%)were stage ?.No stage ? or ?were found in the group.67 operations of laparoscopy were performed while 43 of them were laparotomy.Among them there were 45 unilateral oophorectomy,31 unilateral cystectomy,6 bilateral cystectomy and 9 cases unilateral oophorectomy complicated with contralateral cystectomy according to the surgery record in history.8 patients were treated with adjuvant chemotherapy,following fertility reserving operation.Menstrual abnormalities were observed in 10 patients after operation or chemotherapy.Recurrence was found in 17 patients during time span.9 of them were within 2 years and 1 patient died owing to disease progression.Only 2 case of malignant transformation was found.Of all the 110 cases,65 patients have fertility wish.34 of 65(52.3%)conceived spontaneously.Among the other 31,there were 4 being pregnant after receiving reproduction technology treatment after operation or chemotherapy.Both recurrence rate and fertility rate of UC-group is higher than those of the UO-group with significant difference(P<0.05).No significant difference on the recurrence rate between the chemo-and no-chemo-group were found.Conclusions:1.BOTs are commonly found in young women with no significant symptoms.Routinely or yearly health-check-ups are highly recommended for the early diagnosis and treatment of BOTs.Conservative surgery is a preferable option for patients with desire to retain their fertility potential although the recurrence rate is higher.The menstruation and endocrine functions can be altered in different degrees due to destructions of normal ovarian tissue which should be protected carefully.Chemotherapy after operation is not routinly recommended.2.Both recurrence rate and fertility rate of UC-group is higher than those of the UO-group.Choice must be made throughly in unilaterally involved patients.Neither biopsy of offside ovary or retroperitoneal lymphnodes dissection is recommended routinely.Laparoscopic surgery should be considered carefully as the possibility of cyst rupture rises with many reasons.3.Fertility-sparing surgery for women with recurrent BOT can still be considered if preserving ferility is requested strongly.Carefully follow-up is highly needed especially within 2 years in all BOT paients.Supersonic inspection and serum tumor markers are suggested during follow-up. |
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