Analysis Of Clinicopathological Features And Prognostic Factors Of Borderline Ovarian Tumors

Objective:The patients admitted to the gynecological ward of the affiliated hospital of Inner Mongolia medical university for 8 years were retrospectively analyzed.And the clinical and pathological characteristics of serous borderline ovarian tumors,mucinous borderline ovarian tumors and mixed BOT were compared,and the prognostic factors of patients with ovarian borderline tumors were analyzed.Methods:To collect the clinical data of 88 patients who underwent first operation in the Affiliated Hospital of Inner Mongolia Medical University from January 2006 to January 2014 and were diagnosed as BOT after operation,including age at diagnosis,symptoms,normal menstruation,fertility,tumor marker value,tumor diameter,surgical range,surgical approach,tumor pathological characteristics,clinical staging,and postoperative adjuvant chemotherapy.Comparative analysis of clinicopathological features among the three groups of SBOT,MBOT,mixed BOT.Through the follow-up of the patients after operation,the telephone follow-up reserved by the patients and their families,and the home-to-door follow-up,the recurrence of the patients after operation was found out,and the factors affecting the prognosis were analyzed.SPSS 22.0 statistical software was used to collect and process all the data.The test level was statistically significant(P<0.05).Results: In this study,88 BOT patients with complete data included SBOT41,MBOT39 and mixed BOT8.The age distribution was 16-73 years,with the mean age of onset(41.94 13.75 years)and median age of onset 45 years.There were 8 patients with abnormal vaginal bleeding as the main symptom,30 patients with lower abdominal distension pain as the main symptom,3 patients with abnormal vaginal discharge as the main symptom,9 patients with frequent and urgent urination as the main symptom,1 patient with conscious thickening of abdominal circumference,and 37 patients without symptoms.There were 74 cases with regular menstruation and 14 cases with irregular menstruation.Preoperative CA125 increased in 38 patients,CA199 increased in 28 patients,AFP increased in 4 patients,CEA increased in 8 patients,and HE4 increased in 6 patients.Tumors diameter ranges from 4-58 cm.There were 77 cases of unilateral tumor and 11 cases of bilateral tumor.All the 88 patients received surgical treatment,including 75 cases of open surgery and 13 cases of laparoscopic surgery.There were 41 cases of fertility preservation surgery,including 20 cases of cyst removal and 21 cases of adnexectomy.There were 6 cases of total staged surgery,among which 2 cases were staged surgery to preserve the reproductive function.There were 3 cases of peritoneal implantation.There were 11 cases of microinvasion.There were 79 FIGO stage I patients,7 stage II patients,2 stage III patients,and no stage IV patients.Postoperatively,7 patients received adjuvant chemotherapy,6 received TC(paclitaxel+ carboplatin)chemotherapy with 1-5 courses,and 1 received cisplatin peritoneal heat perfusion + paclitaxel monotherapy.The recurrence rate was 9.09% in 8 cases.By the end of follow-up,there were no deaths.Among the three groups of SBOT,MBOT and mixed BOT,there were statistical significance in tumor diameter,preoperative CA125 level,cumulative single and bilateral ovaries,number of pregnancies,and cyst ablation.In the univariate analysis affecting the prognosis,there were statistically significant differences in FIGO stage,micro nipple,fertility preservation surgery,and cyst ablation.In the multivariate analysis affecting the prognosis,age,FIGO stage,fertility preservation surgery and cyst ablation were all risk factors for BOT recurrence.Conclusions: 1.The onset of BOT is hidden,and most patients have no self-conscious symptoms;2.The diameter of MBOT is larger than that of mixed BOT and larger than that of SBOT;3.The preoperative CA125 level of SBOT was higher than that of MBOT,and the CA125 level of mixed BOT was higher than that of MBOT;4.The probability of bilateral ovarian tumor involvement in SBOT patients was higher than that in mixed BOT patients and higher than that in MBOT patients;5.The number of preoperative pregnancies of MBOT patients was more than that of mixed BOT;6.Age,FIGO stage,micro nipple,fertility preservation surgery and cyst ablation are high risk factors affecting prognosis;7.The prognosis of the patients was not affected by menstruation,comprehensive staging surgery,bilateral ovary involvement,number o production,pathological type,peritoneal planting,surgical approach,micro-infiltration and adjuvant chemotherapy.