The Clinical Features And Prognosis Of Unexpected Ovarian Malignancy Found By Operative Laparoscopy

Objective：By the method of retrospective analysis, to assess the characteristics,intraoperative, postoperative management and implication for prognosis of theunexpected epithelial ovarian malignant tumors found during operative laparoscopy,give a better guide to clinical work.Methods： A total of27patients with epithelial ovarian malignant tumors weretreated by laparoscopy at Da lian Maternity Hospital from January2002to December2010. Their clinical data were reviewed retrospectively. Study randomly selected54cases of ovarian benign epithelial neoplasm in laparoscopic and53cases of early stageepithelial ovarian cancer in open surgery with the same period; collected the patient’spreoperative clinical data, intraoperative and postoperative treatment, andprognosis.Application of ovarian cancer EORTC QLQ-C30V3.0questionnaire testingquality of life. Compare the clinical features of unexpected epithelial ovarian cancerfound by laparoscopic surgery (LEOC) to benign epithelial ovarian tumors bylaparoscopic surgery (LBEOT) and early epithelial ovarian cancer by open surgery(AEOC); compare the prognosis influences of different treatment approaches on LEOCand AEOC; compare the prognosis influences of ovarian cyst burst or not in LEOC. Thedata use SPSS11.5software system to process. When P<0.05, study have statisticallysignificant.Results:1）72ovarian tumors were subsequently found to be malignant out of the3773laparoscopic ovarian tumor surgery in9year．Among which37were borderlinetumors and35ovarian cancers (epithelial ovarian cancer and27cases, malignant germcell tumors in1,and sexual cable interstitial tumor in7cases). The incidence is1.9%.2） In the comparison of LEOC and LBEOT preoperative clinical features, the differencesof abdominal pain, CA125, color ultrasonic blood flow resistance and cysts nature havenotable statistically significan（tP<0.05）. But the differences of age, gravidity numbers,pregnancy numbers, tumor size, abdominal distension and urinary urgency have nostatistically significant.3）In the comparison of LEOC and AEOC preoperative clinicalfeatures, the differences of CA125, tumor size and urinary urgency have notablestatistically significant（P<0.05）. But the differences of age, gravidity numbers,pregnancy numbers, abdominal pain, abdominal distension, color ultrasonic blood flowresistance and cysts nature have no statistically significant.4）The median survival timeof LEOC and AEOC were27months and37months. The differences have nostatistically significant. LEOC and AEOC of3years of survival rates were100%,92%.The differences have no statistically significant.5） The median survival time ofLaparoscopic surgery transfer line in open during stage and Laparoscopic surgeryinstallment scores again and Completed during laparoscopic installment patients were27months,33months and24months. The differences have no statisticallysignificant.6） During laparoscopic surgery, the median survival time of the unruptured,the burst and intraoperative burst patients were27months,19months and29months.The differences have no statistically significant.7） In laparoscopic surgery, the mediansurvival times of patients who keep reproductive function and don’t keep reproductivefunction were24months and27months. The differences have no statisticallysignificant.8）laparoscopic group and in the open group ovarian cancer patients EORTCQLQ-C30V3.0questionnaire survey, laparoscopic group of overall health, physicalfunction, the role of function, emotional function, social function, fatigue, nausea andvomiting, pain, loss of appetite, constipation, diarrhea and economic difficulties andopen group compared are significantly different statistics (P <0.05).Conclusions:1）The incidence of the unexpected ovarian malignant tumors foundduring operative laparoscopy is1.9%. Because the LEOC patients’ preoperativecharacteristics, abdominal pain, color ultrasonic blood flow resistance and cystic naturetended to malignant, so need pay attention to preoperative evaluation.2）The epithelialovarian cancers which unexpected found during operative laparoscopy were early stage.Laparoscopic or abdominal staging surgery didn’t affect the survival time of patients. Iftechnology meet the requirements, laparoscopic surgery is better.3）For the epithelialovarian cancer which unexpected found during operative laparoscopy, both stagingoperation and postoperative short-term operation had no influence on the survival time of patients.4）During laparoscopic surgery, cyst burst of epithelial ovarian cancerpatients had no effect on the survival time, but should try to avoid infection caused bycyst burst.5）For early epithelial ovarian cancer, whether keep reproductive function ornot didn’t affect the survival time. For the young early epithelial ovarian cancer patientswho want to keep reproductive function, we can give the surgery and close follow-up.6）Laparoscopic surgery epithelial ovarian cancer early postoperative patients live qualityis obviously superior to open surgery patients.