The Clinical Study Of Borderline Ovarian Epithelial Tumors In135Cases

ObjectTo study the clinical and pathological features, and to evaluate the management and prognosis of borderline ovarian tumors.MethodsThe medical records of patients with borderline ovarian tumor (BOT) who underwent surgery at Shandong Provincial Hospital in the last8years were retrospectively analyzed, including main clinical symptoms, assistant examination and treatments. Patients who received fertility-sparing surgery had a careful follow-up, the results of recurrence and pregnancy were collected. All data were analyzed by SPSS16.0, the Chi-Squared and Fisher’s exact tests was employed to the univariate analysis.ResultsThe mean age of135BOT patients was41.5+18.4years (range12-86). The histological types:serous (SBOT),58cases(43.0%); mucinous (MBOT),71cases(52.6%); mixed,6cases(4.4%), the disease incidence of MBOT is higher than the other types. Cases involving bilateral ovary:SBOT13(22.4%), MBOT4(5.6%), mixed-BOT0(0.00%).53of the BOTs were found by health examination,43cases had abdominal pain and distension,25cases were abdominal mass,8cases had vaginal bleeding,7cases for urinary system symptom. Before the operation,124patients had CA125measurement,74cases (59.7%) had positive result;84cases had CA199 measurement,23cases (27.4%) had positive result;93cases has CEA measurement,10cases (10.8%) had positive result; the serous-BOT patients had a higher positive result of CA125(75.9%), the serum concentration ofCA125, CA199, CEA has significant difference between different histology types (P<0.05). All the135patients did ultrasonic examination,22SBOT cases had multilocular cyst (37.9%),54MBOT cases had multilocular cyst (76.1%),3mixed-BOT cases had multilocular cyst (50.0%). Among135cases,7cases did not have frozen section,20cases were under-diagnosed for benign tumor (15.6%),1cases was over-diagnosed for malignant tumor (0.8%), accuracy of intraoperative frozen section diagnosis was83.6%. The FIGO stage:122cases were stage Ⅰ(90.4%),6cases were stage Ⅱ(4.4%),7cases were stageIII(5.2%), most patients were diagnosed at early stage. All of them received surgery,80cases(59.3%) underwent fertility-sparing surgery,55cases(40.7%) underwent radical surgery,21cases received adjuvant chemotherapy. The different type of BOT surgery at the same clinical stage has significant correlation to patient’s age (P<0.05), but not to histological type (P>0.05). The adjuvant chemotherapy relates to the clinical-pathological stages and surgery (P<0.05), but not to histological type (P>0.05).59patients who underwent fertility-sparing surgery had a follow-up in80cases,21cases were lost. After a follow-up period range4months to104months,4cases (6.8%) developed disease recurrence all of whom received second-round surgery.47patients wish to pregnant, and15pregnancies were achived, resulting in10deliveries (21.3%). Among4cases with disease recurrence,4were in the cystectomy-only group and0from the unilateral salpingo-oophorectomy group, the difference had statistical significance (P<0.05).ConclusionBorderline ovarian tumors are diagnosed at younger age and earlier stage, while there are no special clinical symptoms with BOT, health examination, serum tumor markers and ultrasonic examination can contribute to early diagnosis. Intraoperative frozen section diagnosis of BOT has a low accuracy, surgical management based on intraoperative frozen section diagnosis should be used with caution. Choose of the surgery type relates to the clinical stages and patient’s age; the adjuvant chemotherapy has relations to the clinical-pathological stages. Fertility-sparing surgery is an safe and acceptable option for early stage BOT patients who wish to preserve fertility; the surgery for recurrence is necessary, close follow-up is required.