The Clinical And Pathological Analysis Of Borderline Ovarian Epithelial Tumors In30Cases

Objective：To evaluate the clini-pathological features，treatment，prognostic factorsof epithelial borderline ovarian tumors.Methods:A retrospective analysis of30patients with borderline ovarian epithelialtumors in patients with clinical and pathological data.We compared clinical features betweendifferent histologic types.The primary comparison is age, disease characteristics, treatment,prognosis and factors affecting recurrence in serous and mucinous tumors.Results:The mean age of30BOTs was42.9.The histological types:15cases weremucinous tumors(50%),10cases were serous tumors(33.3%),5cases were othertypes(16.6%).24patients(80%)were at FIGO stage I,6patients(20%)at stage III.There wasno patients at stagestage II and IV.Perceived abdominal mass treatment of13cases (43.3%),abdominal pain and distension performers were eight cases (26.7%), frequent urination,defecation, urination, poor compression symptoms in3cases (13.3%), lumbosacraldiscomfort patients (10%), physical examination found two cases, menstrual changes in2cases (6.7%).Abdominal distension in patients with ascites and lower extremity edema, Inthe patient of abdominal distension，1case is accompanied by with ascites and lowerextremity edema，1patient with fever,1patient with ovarian cyst torsion.In the30cases ofBOTs patients,all the patients did CA125and CA199inspection preoperation,17cases hadthe positive result of CAl25(56.7%),6cases had the positive result ofCAl99(20%).50%(12/24)patients of phaseⅠand83.3%(5/6)of phase Ⅲ had the positiveresult of CAl25.The tumors stage were later,the positive result of CAl25was higher.theaverage diameter of Serous and mucinous tumors was93.1mm and169.4mmrespectively.Mucinous tumor volume was significantly higher than the serous tumors.Duringthe operation,17patients did inspection of ascitic fluid exfoliative cytology,3cases foundtumor cells.Frozen pathological examination in26cases,22cases of borderline tumors,2cases of benign,2cases of gastric malignant.22cases had the same result with postoperativeparaffin pathological examination,which accuracy rating was84.6%.Surgery is the primarymeans to treat borderline ovarian tumors.During the30patients,16patients underwentsurgery to preserve fertility, and14cases of uterine oophorectomy surgery.3cases did comprehensive stage surgery,all of them below20years old，and require preservation ofreproductive function.There was no recurrence, who underwent comprehensive surgicalstaging.In the4cases of recurrence patients，2patients were still Borderline tumors.2patients developed ovarian serous invasive,13cases of patients underwent chemotherapyafter operation, including carboplatin chemotherapy and intraperitoneal perfusion.5-yearoverall survival and disease free survival rates were96.3%and85.2%respectively.Surgicalstaging and exfoliative cytology of ascites as main factors affecting prognosis of BOTs(P<0.05).Conclusions： The BOTs prognosis is better, especially younger without riskfactors.Despite the frozen pathological examination had higher accuracy，but it was betterto use paraffin slicing results guiding operation methods， to avoid surgery scopeinsufficiency or surgery scope oversized.Operation is the main treatment.Conservativesurgery for younger patients with BOTs is safe.But regular follow-up is necessary forrecurrence，especially for the patients who had high risk factors.The chemotherapy cannotsignificantly reduce recurrence rate and improve the5-year survival rate.