Analysis Of 240 Cases Of Borderline Ovarian Tumor

Objective:The clinical features,intraoperative exploration,pathological diagnosis and treatment plan of 240 cases of ovarian borderline tumors were retrospectively analyzed to provide guidance for the problems in the diagnosis and treatment of BOT.Meyhods:Retrospective analysis of the clinical data of 240 patients with ovarian borderline tumors admitted to the Shandong Provincial Hospital from January 2008 to March 2018.The main researches include:1.Age distribution,clinical features,2.Intraoperative exploration and pathological diagnosis:maximum diameter of tumor,tumor involving ovarian condition,ascites,FIGO stage,histopathological type and special pathological type;3.Diagnosis Indicators:preoperati-ve CA125,CA199 and intraoperative frozen sections;4.Treatment methods:different surgical procedures,surgical access,re-surgical surgery and adjuvant chemotherapy;5,postoperative follow-up and so on.Statistical analysis was performed using a variety of statistical methods.All statistical tests were two-sided,with a test level of 0.05.Statistical analysis was performed using SPSS 24.0.Results:1.Age distribution and clinical features:BOTs patients aged 8 to 91 years,the average age was 41.6±17.1 years.The main reason for the patient's visit:116 cases(48.3%)were unintentionally found in the pelvic mass,39 cases(16.3%)were abdominal mass or bulging,72 cases were abdominal discomfort,4 cases(1.7%)were vaginal bleeding,and the other 7 cases(2.9%).2.Intraoperative exploration and pathological diagnosis:Of the 240 patients with BOT,52(21.7%)had bilateral ovaries and 188(78.3%)had unilateral ovaries.Intraoperative exploration of 165 people without ascites(69.6%),63 patients with ascites(26.2%).Of the 240 patients in the study,134 were sBOT(55.8%),98 were mBOT(40.8%),and 8 were other histological types(3.4%).According to the postoperative pathology,the exact staging was as follows:198 cases(82.5%)in stage? stage,15 cases(6.3%)in stage ?,27 cases(11.2%)in stage ?,and no stage IV in patients.Of the 240 patients,221 patients underwent preoperative tumor marker serum CA125,with a positive rate of 54.8%.There were 135 CA199 preoperative tests,and the positive rate was 26.0%.Statistical analysis showed that there was a significant difference in tumor recurrence between the bilateral ovaries and ascites,and there was no statistically significant difference in the recurrence of ascites and CA125.3.Frozen section:230 patients in this study were frozen and accurately diagnosed 182(79,1%)with a sensitivity of 80.9%.The results of sBOT and mBOT frozen sections were 85.8%and 69.5%,respectively,and the sensitivity was 87.2%and 70.9%.Statistical analysis showed that histological type(P=0.011),tumor maximum diameter(P<0.05),tumor involvement ovarian condition(P=0.041)and microinfiltration(P=0.001)were statistically significant differences in misdiagnosis of frozen sections.There was no significant difference in the diagnostic accuracy of frozen sections between the age of patients(P=0.464),surgical approach(P=0.645),and FIGO stage(P=0.288).4.Treatment strategy:124 patients underwent conservative operation(51.7%)and 116 underwent radical surgery(48.3%).Among them,18 patients underwent pelvic/abdominal para-aortic lymph node dissection,and the pathological results were all negative.The difference in PFS and OS was significant in lymph node resection.(P = 0.002,P = 0.006).Among the 35 patients with FSS ovarian cystectomy,the 5-year recurrence rate was 28.6%;88 patients with BOT who underwent attachment resection in the FSS had a 5-year recurrence rate of 9.1%.5.Follow-up:The average follow-up time was 63.7±35.9 months.A total of 22 patients relapsed in this study.The recurrence rate after BOT was 9.2%.The histological type of recurrent patients was still a good prognosis for borderline tumors,and only one person had malignant transformation.The number of deaths has been 9 since the follow-up,of which only 1 is associated with BOT.Variables were screened by logistic regression model and stepwise regression.FIGO stage,surgical plan and tumor rupture may be risk factors for recurrence(P<0.05).Conclusion:1.Bots is likely to occur in women of childbearing age and most patients are diagnosed with Figo stage ?.2.Bots was occult and most of the patients had no obvious discomfort or specific symptoms.The diagnosis of BOTs is based on histopathological examination.Frozen sections were often performed during operation,but the accuracy of FS was influenced by mBOT?the maximal diameter of mucinous BOTs.?tumors with microinfiltration.3.FIGO stage,surgical plan,and tumor rupture are risk factors for postoperativerecurrence.