| Objective It may be used as an evidence of the efficacy for selecting preventiveprocedures to conclude the clinicopathological characteristics of borderline ovariantumors and to evalutate their risk factors associated with recurrence and pregnancyrates after fertility-sparing surgery.Methods Various clinicopathologic factors of89patients with borderline ovariantumors admitted to Fujian Medical University Union Hospital between January2002and October2012were reviewed. The effects of clinicopathological characteristicsupon recurrence and fertilty outcomes were analyzed by independent sample t test,Chi-square test and Cox proportional hazard mode.Results The patients’ average age was42.64±17.37years old.The percents ofelevated level on preoperative serum CA125, CA199and CEA were44.05%(37/84),28.40%(23/81) and7.79%(6/77) respectively.42(47.19%) patients having receivedconservative surgery included28cases with unilateral oophorectomy and14caseswith unilateral or bilateral ovarian cyst-ectomy,while47cases (52.81%) receivedradical surgery.17cases underwent comprehensive surgical staging.There were11patients operated by the way of laparoscopic surgery and78done by laparotomy.10patients had postoperative adjuvant chemotherapy, the regimens of which weremainly a platinum-based intravenous chemotherapy. Mean size of the tumors was(13.93±8.94) cm. MBOT’s size was18.21±9.33cm,while SBOT’s was9.13±5.40cm.82cases (91.01%) were limited to unilateral ovary. Serous(47.19%) andmucinous(51.69%) tumors were dominnant histological types of BOT. We found3patients with intraepithelial carcinoma,1caes with micro-invasive carcinoma and2cases with pseudomyxoma peritonei. There were74cases in Stage Ia,2cases in Ib,3cases in Ic,5cases in II and still5cases in III, respectively among89patients. Meanduration for follow-up was25.97±16.93months.8cases (8.99%) patients hadrecurrence,but no one tumor-related death was reported as far. Median duration fromsurgary to recurrence was25.25months. The recurrent rate of Stage II or III was2/5or3/5, which was significantly higher than that of stage Ia+Ib (2.63%,2/76,P<0.05).One of the2pseudomyxoma peritonei appeared recurrence.Bilateral lesions’ recurrentrate was greater than unilateral lesions’.The significant difference occurred on therecurrence between cases between postoperative adjuvant chemotherapy and oneswho didn’t. However, there were no effect on recurrent rate whether concurrent intraepithelial, micro-invasive carcinoma or not, either comprehensive stagingsurgery. FIGO stages is an independent risk factor for BOT recurrence (OR=2.298, P<0.05). Before surgery there were33patients who had never been pregnant. Theyreceived fertility-sparing surgery and10of them succeeded in spontaneouspregnancy after operation. The pregnany rates of the2ways for conservative surgerywere not significantly different.(P>0.05).Conclusion Majority of BOT are diagnosed in early stage and young (20-50yearsold), have favorable prognosis. CA125, CEA, CA199can be used as indicators ofpreoperative prediction and monitoring recurrence for BOT. The conservative surgeryfor patients with BOT should be considered for women who are young and desirepreservation of fertility. However, careful follow-up is needed to detect recurrentdisease in these patients. Whether comprehensive staging surgery or not does notaffect the BOT recurrence rate, either do the cases with intraepithelial and mico-invasive carcinoma. Postoperative chemotherapy will not reduce the recurrence rateof BOT. Generally, MBOT is larger than SBOT in size, but the size of tumor andhistological types are not associated with recurrence. Canceration is also not directlyrelated to recurrence, and the majority pathologic type of recurrent tumors is still BOT.The cases who are aged,with bilateral lesions, with PMP are more likely to recurrence.Advanced-stage BOTs (stage II-IV) patients have higher rates of recurrence thanearly-stage ones(stage I). FIGO stages is considered as an independent risk factor forrecurrent BOT. |
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