| Ovarian tumors are common gynecological tumors,which can occur at any age,and their occurrence is hidden.When discovered,they are often at an advanced stage,lacking effective treatment methods,and their mortality rate ranks first among gynecological malignancies.However,borderline ovarian tumors are characterized by their special pathomorphological characteristics and prognosis far better than most ovarian malignant tumors.In recent years,they have come into the eyes of obstetricians and gynecologists.They have young onset,slow disease progression,and malignancy.Patients with low fertility requirements have various particularities.After decades of clinical practice,clinicians have gradually explored the characteristics of the disease,and combined clinical experience to formulate effective treatment measures,which are conservative for patients with fertility requirements.Surgery is particularly concerned and important.With the reports of large samples of high-quality clinical studies,there is a lack of combined statistical analysis of multiple independent studies.This article aims to apply the statistical method of meta-analysis to compare conservative surgery to radical surgery for recurrence.From the perspectives of rate,survival rate,and pregnancy rate,a unified conclusion can be drawn to provide evidence for clinicians’ practice.Objective:A systematic review of the feasibility of conservative surgery in borderline ovarian tumors provides a basis for accurate clinical decision-making.Method:Search Pub Med,EMbase,The Cochrane Library,Medline,CNKI,CBM,VIP,Wanfang and other databases to collect all published studies on conservative surgery for borderline ovarian tumors.The search time limit is from January 1,2010 to 2021.On January 1,the included studies were screened and synthesized in strict accordance with the evaluation criteria,and data and information were extracted using stata 16 software for meta-analysis.Result:(1)Twenty-four studies were included,with a total of 4707 patients,including2345 conservative surgery and 2330 radical surgery.After the heterogeneity test was taken,there was heterogeneity between each study(I2=52.76%,P=0.00).After excluding clinical heterogeneity,the random effects model was used for combined analysis.The results showed that the postoperative recurrence rate of conservative surgery was 15.82%(137/2345),which was higher than that of radical surgery 6.3%(147/2330),and the difference was statistically significant(OR=3.31,95%CI: 2.18-4.51,P=0.000).(2)Included in 9 studies,a total of 2091 patients,including 1004 cases of fertility sparing surgery and 1058 cases of radical surgery.The heterogeneity test showed that there was no significant heterogeneity between the studies(I2=0.00%,P=0.69),and the fixed effects model was used for merging.The results showed that there was no statistical difference in postoperative survival between conservative surgery and radical surgery(HR=-0.02,95%CI:-0.11-0.07).(3)A total of 6 studies reported conservative surgery in BOT patients In the postoperative pregnancy,30 of the 40 pregnant patients succeeded 33 times,and the pregnancy rate was 75%.Five studies on the full-term pregnancy rate,the full-term birth rate reached 86.17%.Conclusion:Conservative surgery is feasible for young BOT patients with fertility requirements.Even if the postoperative recurrence rate is significantly higher than that of radical surgery,it has no significant impact on the survival rate,and re-pregnancy after surgery is feasible,and the overall pregnancy rate is higher. |
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