Analysis Of Clinicopathological Features And Prognosis Of Ovarian Junction Tumor

Objective:Ovarian borderline tumor is a kind of ovarian epithelial tumor with low malignant potential between benign and malignant,and its incidence is about 10-15%.The prognosis of ovarian junction tumor is good,the 5-year survival rate is more than 80%.At present,the main treatment is surgery,but because it is still low grade malignant tumor,there is a possibility of recurrence and malignant change.So far,most scholars believe that the possible factors affecting the prognosis of ovarian junction tumor are:micro-papillary type,tumor stage,surgical mode,extraovarian implantation,intraoperative tumor rupture,etc.,but the risk factors affecting recurrence have not been unified at present.This study collected the clinical case data of patients with ovarian borderline tumor and followed up their prognosis.Through statistical analysis,different clinicopathological features were obtained.The aim was to find out the high risk factors that affected the prognosis of patients with ovarian borderline tumor,and to provide reference for the treatment and follow-up of patients with ovarian borderline tumor.Method:The clinical data of 155 patients with ovarian borderline tumors admitted from September 2012 to March 2018 in the third affiliated hospital of Kunming Medical University(Yunnan Cancer Hospital)were collected,including:1.age of onset,2.preoperative serum tumor marker level(CA125?CA199?CEA),3.surgical approach,operation mode,whether the tumor ruptured during operation,lymph node resection,peritoneal lavage fluid or ascites cytology,4.postoperative pathological types,FIGO stages and adjuvant chemotherapy were analyzed retrospectively.SPSS21.0 software was used for statistical analysis.for metrological data,descriptive statistical analysis used mean,standard deviation,etc.,the comparison of mean between two groups used independent sample t test;for categorical variables,the comparison of inter-group rates used chi-square test or Fisher accurate test;recurrence as the endpoint event,survival curve analysis using Kaplan-Meier method,survival curve comparison using Log-rank test;use of Cox regression on ovarian tumor patients related factors for disease-free survival analysis.all hypothesis tests were taken at a significant level of 0.05.Results:1.General situation:155 patients with ovarian borderline tumors were collected,the follow-up time was up to May 2020,and the shortest follow-up time was 26 months.There were 49 serous junctional tumors,99 mucinous junctional tumors and 7 serous junctional tumors.The mean onset age was 40 years old(13-82 years old).Serum tumor markers were detected before operation CA125?CA199?CEA,including 111 increased preoperative serum tumor markers CA125?CA199?CEA,124 FIGO stage,11 ? stage,19 stage,1 stage ? stage;All patients underwent surgical treatment,and no residual lesions were observed after operation.107 cases underwent conservative surgery,48 complete stage or tumor cell reduction surgery;Among them,there were 36 cases of tumor resection,71 cases of appendectomy,19 cases of laparoscopic surgery and 136 cases of open surgery.There were 118 cases of unilateral ovarian involvement,37 cases of bilateral ovarian involvement,46 cases of intraoperative tumor rupture and 78 cases of non-ruptured tumor during the I stage of FIGO stage,and pathological features:53 cases with benign focal or focal junction,73 cases with simple junction,19 cases with microemulsion subtype,1 case with microinfiltration,5 cases with intraepithelial carcinoma and 4 cases with focal carcinoma;30 cases with pelvic and abdominal implantation:11 cases with non-invasive implantation and 19 cases with invasive implantation;11 cases with intraoperative lymph node resection,3 cases with positive lymph nodes;Postoperative adjuvant chemotherapy was performed in 21 cases,1 routine intraperitoneal perfusion,the rest were intravenous administration,4 patients in the middle I stage of chemotherapy:2 cases were focal carcinogenesis,1 case of ascites detected adenocarcinoma cells,1 case was microemulsion subtype;the remaining 17 cases were all patients in the ????? stage;follow-up results in 21 cases of recurrence,including 1 case of recurrent death(died of chemotherapy complications),the recurrence rate was 13.5%.2.Statistical results:in univariate analysis,there was no significant statistical difference between the onset age,preoperative serum tumor marker level,common pathological types,surgical route,lymph node resection,ascites or peritoneal lavage fluid cytological results,postoperative supplementary chemotherapy and patient recurrence;while there was significant statistical difference between FIGO staging,invasive implantation,whether there were special pathological types,tumor involvement of unilateral or bilateral ovaries,and operation mode and postoperative recurrence(P<0.05).Factors associated with the prognosis of borderline tumors were included in the Cox regression model.The results of multivariate analysis showed that invasive implantation,tumor involvement of bilateral ovaries and tumor denudation were independent risk factors for recurrence.There was no statistical significance for patients with FIGO stage and I stage,such as surgical approach,rupture of tumor during operation,special pathological type and recurrence after operation.Conclusion(s):1.Ovarian borderline tumors occur in women of childbearing age,mostly early.2.Invasive implantation,tumor involvement of bilateral ovaries and tumor denudation are independent risk factors for ovarian junction tumor recurrence.3.Adnexal resection or full staging was not significantly different from the patient's with recurrence,suggesting that early patients need not be forced full staging surgery.4.Lymph node dissection does not affect prognosis.Lymph node dissection was performed in patients with borderline tumor without lymphadenopathy.5.Chemotherapy does not reduce the recurrence rate of ovarian junction tumor,chemotherapy should be avoided as far as possible.6.The overall prognosis of ovarian junction tumor is better,recurrence is mostly concentrated in 3-5 years,and has no effect on long-term survival.Therefore,it is feasible for young early patients with reproductive requirements to have conservative surgery,improve the quality of life of patients,provide reproductive opportunities.