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Zhang Y, Wang QN, Huang Z, Chu R, Dong TT, Zhang YZ, Yang XS, Jiang J, Cui BX, Song K, Kong B. [Prognosis and fertility outcomes of patients with borderline ovarian tumors after fertility-sparing surgery]. Zhonghua Yi Xue Za Zhi 2022; 102:1999-2004. [PMID: 35817724 DOI: 10.3760/cma.j.cn112137-20211215-02796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the clinical prognosis and fertility outcomes in patients with borderline ovarian tumors (BOT) who underwent fertility-sparing surgery, and evaluate the related risk factors. Methods: The study examined the clinicopathological characteristics of 280 patients diagnosed with BOT from Qilu Hospital of Shandong University between January 2009 and December 2019. According to the surgery plan, the patients were divided into the fertility-sparing group (167 cases) and the radical surgery group (113 cases). The information of the patients' age, preoperative serum CA-125 level, surgery method, pathological type, FIGO stage (2014), tumor location, and whether focal canceration combined were collected. The Kaplan-Meier method was used to compare disease-free survival (DFS) between the fertility-sparing surgery group and the radical surgery group. The univariate and multivariate Cox proportional hazard regression analysis was used to explore high-risk factors associated with DFS. Results: A total of 280 BOT patients were identified in the study, with a median age of 35.0 (26.0, 51.0) years old. The median follow-up time was 55.2 (34.7, 79.3)months. 25 patients (15.0%) developed recurrence in the fertility-sparing surgery group, 11 patients (8.7%) developed recurrence in the radical surgery group. There was no significant difference in 5-year DFS rate between the two groups (84.4% vs 90.1%, P=0.223). Only FIGO stage was found to be related to DFS through the univariable and multivariable Cox proportional hazard regression analysis, and patients with FIGO Ⅱ/Ⅲ had higher risk of recurrence [HR (95%CI) 2.872(1.283-6.431)] (P=0.010); Fertility-sparing surgery does not increase the recurrence risk of BOT patients (P=0.116). Pregnancies were reported in 39 patients (54.2%), among whom 37 patients gave birth successfully, and 2 patients selected to terminate pregnancy. Conclusions: The fertility-sparing surgery does not increase the risk of recurrence in BOT patients, and patients who underwent the fertility-sparing surgery have a favorable outcome. FIGO stage is the independent risk factor of DFS in BOT patients.
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Affiliation(s)
- Y Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Q N Wang
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Z Huang
- Department of Gynecology, Ganzhou Maternal and Child Health Hospital, Ganzhou 341000, China
| | - R Chu
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - T T Dong
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Y Z Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - X S Yang
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - J Jiang
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - B X Cui
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - K Song
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Beihua Kong
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, China
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