| Objective:The purpose of this study was to analyze the clinical features of borderline ovarian tumors,to explore the prognostic factors,and to analyze the clinical outcome and value of ovarian tumor stripping in the early stage of borderline ovarian tumors.Methods:1.Retrospective analysis of 125 BOT patients admitted to the first affiliated hospital of kunming medical university from January 2008 to April 2018.2.To analyze the clinical characteristics,fertility and survival of 40 patients with early BOT after ovarian tumor extirpation,and to explore the value of ovarian tumor exfoliation in early BOT.Results:1.The average age of 125 patients was(39.18±16.16)years,117(93.6%)of Han patients and 8(6.4%)of ethnic minorities.The main clinical manifestations are abdominal pain,abdominal distension,low back pain,frequent urination,difficulty in defecation,irregular menstruation,irregular vaginal bleeding,acute abdomen or compression symptoms,conscious or physical examination of pelvic masses.The pathological types included 42 cases of serous borderline tumors,61 cases of mucinous borderline tumors and 22 cases of other types of tumors.No papilla structure was found in 48 cases,and 87 cases had papilla structure under microscope.There were 114(91.2%)cases in stage I,including 14 cases in la stage,4 cases in Ib stage,96 cases in Ic stage,4 cases(3.2%)in II stage,7(5.6%)cases in III stage and 0 cases in IV stage.91(72.8%)cases underwent fertility-preserving surgery and 34(27.2%)cases had non-reserved fertility function.None of them underwent lymph node dissection.There were 11 cases of interstitial microinfiltration(with or without multiple tumor implantation in pelvic and abdominal cavity),including 5 cases of interstitial microinfiltration with multiple implantation of pelvic and abdominal cavity.Postoperative chemotherapy was performed in 7 patients with multiple pelvic and abdominal implantation,including 6 patients treated with TP(paclitaxel,platinum)regimen,1 patient treated with PC(DDP,cyclophosphamide)regimen,3 times for 6 courses of treatment.The mean follow-up time was 50.7±32.5 months.At the end of follow-up,there were 21 recurrent patients and 6 deaths,of which 2 died of recurrence and 4 died of other internal diseases.At the time of initial operation,56 cases(44.8%)did not complete the birth,10 cases were still not married from operation to the end of follow-up,22 cases were pregnant after operation,including 5 cases of abortion or induced labor,and 17 cases of full-term birth and physical fitness.2.The multivariate analysis of tumor recurrence in patients with BOT showed that clinical stage was an independent risk factor for tumor recurrence in patients with BOT(p<0.05).3.The average age of 40 patients undergoing ovarian tumor exfoliation was(28.20±8.13)years.All patients had no family history of tumor,3 patients had history of ovarian tumor exfoliation,and all patients had menstruation at the time of initial operation.At the time of initial treatment,28(70%)had incomplete birth history and 12(30%)had birth history.There were 13 cases of borderline serous tumors,21 cases of mucinous tumors and 6 cases of other types,including 30 cases with papilla structure under postoperative pathological examination.Clinical stage:IA stage 3 cases,Ic stage 37 cases.Unilateral tumor exudation was performed in 30 patients(including 1 case of contralateral ovarian resection and 3 cases of cuneiform resection)and 10 cases of bilateral tumor exudation.Laparoscopic surgery was performed in 28(70%)cases,abdominal surgery in 12(30%)cases.All patients were not treated with chemotherapy.The mean follow-up time was(46.25±23.51)months.All patients survived.Of the 40 patients,3(7.5%)had a definite recurrence,and the mean follow-up time was(46.25±23.51)months,the mean follow-up time was(46.25±23.51)months.The pathology after reoperation was consistent with that of the first operation in 3 patients with recurrence.The other 3 patients were likely to recur.B-ultrasound only suggested the recurrence of ovarian mass.Because the tumor was small,the patient did not want to operate,so he chose to continue the follow-up.There were 27 patients with fertility requirements,13(48.1%)patients with postoperative pregnancy,including 1 patient with 12 weeks of pregnancy+abortion,1 patient with 8 weeks of pregnancy+embryo sterilization,1 patient with cesarean section and 2 children with full-term health.The other 10 patients gave birth to full-term infants and were in good health.14 patients did not take contraceptive measures and were still not pregnant.Among the postoperative pregnant patients,2 patients had miscarriages and 10 patients gave birth smoothly.Conclusion:1.There was no significant difference in postoperative recurrence between the retention of fertility function group and the non-retention fertility function group,but it was feasible to choose to retain the fertility function in the early stage.2.Clinical stage is an independent risk factor for tumor recurrence in patients with BOT.3.It may be safe for patients with early borderline ovarian tumors to undergo tumor extubation. |
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