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山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (8): 61-66.doi: 10.6040/j.issn.1671-7554.0.2023.0343

• 临床医学 • 上一篇    

卵巢交界性肿瘤保留生育功能术后肿瘤预后及妊娠结局

刘昶1,2,王倩男1,张悦1,陈忠绍1,褚然1,姚舒1   

  1. 1.山东大学齐鲁医院妇产科, 山东 济南 250012;2.山东大学齐鲁医学院第一临床学院, 山东 济南 250012
  • 发布日期:2023-08-30
  • 通讯作者: 姚舒. E-mail:yaoshu1992@126.com
  • 基金资助:
    中国博士后基金面上项目(2022M711951),中国博士后基金站前特别资助项目(2022TQ0197),山东省自然科学基金青年项目(ZR2022QH035),山东博士后创新计划(SDBX2022007)

Prognosis and fertility outcomes of patients with borderline ovarian tumors undergoing fertility-sparing surgery

LIU Chang1,2, WANG Qiannan1, ZHANG Yue1, CHEN Zhongshao1, CHU Ran1, YAO Shu1   

  1. 1. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. First Clinical Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
  • Published:2023-08-30

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摘要： 目的 探讨卵巢交界性肿瘤(BOT)患者保留生育功能手术(FSS)后的肿瘤预后及生育结局。 方法 回顾性分析山东大学齐鲁医院妇产科2009年1月至2019年12月接受FSS手术治疗的BOT患者临床资料。单因素及多因素Cox比例风险回归算法用于分析影响BOT患者保育术后无病生存期(DFS)的高危因素;单因素及多因素二分类Logistic回归分析患者术后妊娠的影响因素。 结果 共167例BOT患者纳入研究,术后中位随访56(2~143)个月。随访期间,共有25例(15.0%)患者复发。多因素Cox比例风险回归分析结果显示,仅肿瘤位置(双侧HR=3.908,95%CI:1.751~8.721,P=0.001)与患者DFS有关。在有妊娠意愿的72例患者中共记录到39例(54.2%)患者妊娠,其中37例患者成功分娩,2例患者选择终止妊娠。多因素二分类Logistic回归分析结果显示,病理类型为黏液型(OR=3.279,95%CI:1.104~9.739,P=0.032)、手术入路为腹腔镜(OR=4.199,95%CI:1.462~12.058,P=0.008)的BOT患者FSS术后妊娠成功率更高。 结论 接受FSS治疗的BOT患者总体预后良好,肿瘤位置与术后复发具有独立相关性,病理类型及手术入路与患者术后妊娠结局相关。

关键词: 卵巢交界性肿瘤, 保留生育功能手术, 无病生存期, 妊娠结局

Abstract: Objective To explore the clinical prognosis and fertility outcomes in patients with borderline ovarian tumors(BOT)who underwent fertility-sparing surgery(FSS). Methods A retrospective analysis was conducted on BOT patients who received FSS in Qilu Hospital of Shandong University during Jan. 2009 and Dec. 2019. Risk factors associated with disease free survival(DFS)were determined with univariate and multivariate Cox proportional hazard regression analysis. Risk factors related to postoperative fertility outcomes were assessed with univariate and multivariate binary Logistic regression analysis. Results A total of 167 BOT patients were included and followed up for a median of 56(range 2-143)months, during which 25 patients(15.0%)had recurrence. Multivariate Cox proportional hazard regression analysis showed bilateral tumor(HR=3.908, 95%CI: 1.751-8.721, P=0.001)was related to DFS. Among the 72 patients with pregnancy intention, 39(54.2%)had pregnancy, 37 gave birth successfully, and 2 terminated pregnancy. Multivariate binary Logistic regression analysis showed that mucinous tumor(OR=3.279, 95%CI: 1.104-9.739, P=0.032)and laparoscopic surgery(OR=4.199, 95%CI: 1.462-12.058, P=0.008)were associated with successful pregnancy after FSS. Conclusion BOT patients undergoing FSS have a favorable prognosis outcome; bilateral tumors are correlated with poorer DFS; the pathological type and surgical approach may affect the postoperative fertility outcomes.

Key words: Borderline ovarian tumors, Fertility-sparing surgery, Disease free survival, Fertility outcome

中图分类号: 

  • R737.31
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