Clinical Analysis Of Fertility Preservation In Patients With Ovarian Borderline Tumors During Reproductive Period

Background:Ovarian borderline tumor is a special type of biological behavior between benign and malignant tumors.It has age of onset,no characteristic clinical manifestations,and relatively good prognosis.It has low malignant potential and a certain probability of recurrence.No standard operation method for BOT patients to preserve fertility,It is mainly determined by the clinician according to the patient's condition and the willingness to decide the specific surgical method.The growth period is a high incidence period of ovarian borderline tumors,which is of great significance for its research.Objective:To expect to improve the prognosis of patients with BOT,reduce the recurrence rate and improve pregnancy outcomes.Method:BOT patients admitted to the Second Hospital of Jilin University during the period from October 2010 to April 2018.All of them were treated with conservative therapy.This article use retrospective study to statistical analysis BOT treatment,recurrence rate and influencing factors,prognosis and pregnancy outcome to guide clinician to make a choice about selection of surgical methods for preserve fertility in BOT patients.All patients except for other malignant tumors,severe cardiopulmonary diseases.This study is related to pregnancy and to reduce the interference of age on pregnancy outcomes,all the patients age pregnancy between 20 and 40 years old.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 October 2018.Use the software SPSS 22.0 to analysis the acquired data.Result:1?The mean age of onset in 90 patients was 29.23 ± 5.16 years,and the median age of onset was 28 years.2?The main reasons for the patients were found in routine examinations(55 cases).The patients with gynecological symptoms had abdominal symptoms(23 cases);irregular vaginal bleeding(4 cases);menstrual abnormalities(3 cases).3?5 cases(5.56%)without ultrasound report.Ultrasound report of 85 patients showed: hyperechoic(11.39%);hypoechoic(13 cases)and mix-echoic(34.18%).4?4 patients lost tumor marker information lost,3 patients were normal,CA125 increased(68.6%),CA199 increased(62.79%),HE4 increased(67.44%),three tumor markers were elevated(20.93%).5?39 cases(43.33%)in laparoscopic surgery and 51 cases(56.67%)in open surgery.Unilateral tumor extirpation(41.11%);simple salpingo-oophorectomy(23.33%);bilateral tumor removal(7.78%);staged surgery to preserve fertility(27.78%).IA stage,71.11%;IB stage,1.11%;IC stage,24.45%;2.22% in stage IIB;stage III(1.11%).6?serous fluid(50%);mucus(35%);15 cases of other types.A total of 11 patients with chemotherapy(12.22%),5 cases of recurrence(45.45%).7?There were 53 cases with fertility requirements,40 cases(75.47%)with successful pregnancy,and 13 cases(24.53%)without pregnancy.There were differences in pregnancy between different surgical methods,and the pregnancy rate of staged surgery between 20-30 years old(77.78%).The pregnancy rate of staged surgery between 30-40 years old(15.38%).8?7 patients was relapsed(7.78%).The shortest interval of recurrence was 6 months and the longest interval was 48 months.40 successful pregnancies.One patient who was receiving IVF treatment found a significant increase in the volume of recurrent ovarian tumors during IVF treatment.The neonatals were normal.One patient had a recurrence of ovarian tumors after 3 months of follow-up.It is still in pregnancy,and 2 patients have not undergone surgery.Conclusion:1?There was no statistically significant effect of surgical path,surgical procedure,tumor location,and FIGO staging on postoperative recurrence.For BOT patients with a small tumor volume and no history of multiple abdominal surgery,the surgical procedure is preferred for laparoscopy.2?Between the ages of 20 and 30,regardless of the unilateral/bilateral ovarian retention,the surgical procedure had no effect on the postoperative pregnancy rate;the bilateral ovaries were retained between the ages of 30 and 40,and the surgical procedure had no effect on the postoperative pregnancy rate;Patients with only one unilateral ovarian pair between the ages of 30 and 40 have a larger surgical range and a lower pregnancy rate.Patients of different ages are choosing the most effective operation path.3?Chmotherapy is not effective in preventing recurrence.4?CA199 is usually found in common types of BOT,more common in M-BOT and the difference is statistically significant.