Analysis Of Factors Influencing Postoperative Recurrence Of Ovarian Borderline Tumors And Fertility Status Abstract

Objective: The purpose of this study was to provide theoretical basis for the treatment of ovarian borderline tumors by retrospective analysis of 249 patients with ovarian borderline tumors who underwent initial surgical treatment in our hospital,to study the influencing factors of postoperative recurrence of ovarian borderline tumors and postoperative fertility of patients with fertility preservation function.Methods: A retrospective analysis was conducted on 249 patients who were pathologically diagnosed as ovarian borderline tumor and initially treated with surgery in the fourth hospital of hebei medical university during May 1,2005,solstice,August 31,2018.The clinical and pathological data of the patients were reviewed in detail and an Excel database was established.SPSS21.0 statistical software was used for statistical analysis of the data.Chi-square test was used for single-factor analysis,and multifactor Logistic regression analysis was used for multifactor analysis.P < 0.05 was statistically significant.Results:In this study,the recurrence rate of 77 patients younger than 30 years old was 24.68%,the recurrence rate of 30 to 50 years old was 7.45%,and the recurrence rate of patients older than 50 years old was 7.69%,the difference was statistically significant(=13.917,P=0.001).Multivariate analysis showed that mucinous tumor,FIGO stage ii-iv and fertility preservation surgery were independent risk factors for recurrence.The risk of postoperative recurrence was nearly 5 times higher in patients undergoing fertility preservation surgery(OR=5.275,95%ci =2.229~8.681).Among patients undergoing fertility preservation surgery,the recurrence rate of unilateral BOT cyst ablation was 26.09%,and that of unilateral addendum ablation was 9.09%.The difference between the two groups was statistically significant(=6.369,P=0.012).The DFS of unilateral adnexectomy is longer.The recurrence rate of bilateral tumor ablation was 44.44%(4/9)among the patients with bilateral BOTs retained reproductive function,and 33.33%(1/3)among the patients with one side tumor ablation and one side addenectomy.In this study,136 cases retained fertility function,and the postoperative pregnancy rate was 22.79%.The pregnancy time required by laparotomy patients was less than that of the laparoscopic group,with a statistically significant difference(=-3.078,P=0.005).The pregnancy rate of the laparoscopic group was 21.43%,lower than that of the open group(24.05%).However,due to the short follow-up time,the analysis evidence of pregnancy-related factors is slightly insufficient,which still needs further follow-up.Conclusions:1.The younger the patients were,the higher the risk of BOTs recurrence was.2.Mucinous tumor,FIGO stage II-IV and fertility preservation surgery were independent risk factors for recurrence.3.Laparotomy may shorten the time required for postoperative pregnancy and increase the probability of pregnancy.