Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (8): 61-66.doi: 10.6040/j.issn.1671-7554.0.2023.0343

• 临床医学 • Previous Articles    

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

PDF (PC)

143

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

CLC Number: 

  • R737.31
[1] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J]. CA Cancer J Clin, 2021, 71(3): 209-249.
[2] Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants [J]. Chin Med J, 2022, 135(5): 584-590.
[3] Wang L, Zhong Q, Tang Q, et al. Second fertility-sparing surgery and fertility-outcomes in patients with recurrent borderline ovarian tumors [J]. Arch Gynecol Obstet, 2022, 306(4): 1177-1183.
[4] Hannibal CG, Huusom LD, Kjaerbye-Thygesen A, et al. Trends in incidence of borderline ovarian tumors in Denmark 1978-2006 [J]. Acta Obstet Gynecol Scand, 2011, 90(4): 305-312.
[5] Morice P, Uzan C, Fauvet R, et al. Borderline ovarian tumour: pathological diagnostic dilemma and risk factors for invasive or lethal recurrence [J]. Lancet Oncol, 2012, 13(3): e103-e115.
[6] Zanetta G, Rota S, Chiari S, et al. Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study [J]. J Clin Oncol, 2001, 19(10): 2658-2664.
[7] Falcone F, Malzoni M, Carnelli M, et al. Fertility-sparing treatment for serous borderline ovarian tumors with extra-ovarian invasive implants: analysis from the MITO14 study database [J]. Gynecol Oncol, 2022, 165(2): 302-308.
[8] Daraï E, Fauvet R, Uzan C, et al. Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options [J]. Hum Reprod Update, 2013, 19(2): 151-166.
[9] Yahata T, Banzai C, Tanaka K, et al. Histology-specific long-term trends in the incidence of ovarian cancer and borderline tumor in Japanese females: a population-based study from 1983 to 2007 in Niigata [J]. J Obstet Gynaecol Res, 2012, 38(4): 645-650.
[10] Schuurman MS, Timmermans M, van Gorp T, et al. Trends in incidence, treatment and survival of borderline ovarian tumors in the Netherlands: a nationwide analysis [J]. Acta Oncol, 2019, 58(7): 983-989.
[11] Armstrong DK, Alvarez RD, Backes FJ, et al. NCCN guidelines® insights: ovarian cancer, version 3.2022: featured updates to the NCCN guidelines [J]. J Natl Compr Canc Netw, 2022, 20(9): 972-980.
[12] Mutch DG, Prat J. 2014 FIGO staging for ovarian, fallopian tube and peritoneal cancer [J]. Gynecol Oncol, 2014, 133(3): 401-404.
[13] Fischerova D, Zikan M, Dundr P, et al. Diagnosis, treatment, and follow-up of borderline ovarian tumors [J]. Oncologist, 2012, 17(12): 1515-1533.
[14] Buonomo B, Peccatori FA. Fertility preservation strategies in borderline ovarian tumor recurrences: different sides of the same coin [J]. J Assist Reprod Genet, 2020, 37: 1217-1219.
[15] Sangnier E, Ouldamer L, Bendifallah S, et al. Risk factors for recurrence of borderline ovarian tumors in France: a multicenter retrospective study by the FRANCOGYN group [J]. J Gynecol Obstet Hum Reprod, 2021, 50(4): 101961.
[16] Bourdel N, Huchon C, Abdel Wahab C, et al. Borderline ovarian tumors: Guidelines from the French national college of obstetricians and gynecologists(CNGOF)[J]. Eur J Obstet Gynecol Reprod Biol, 2021, 256: 492-501.
[17] du Bois A, Ewald-Riegler N, de Gregorio N, et al. Borderline tumours of the ovary: a cohort study of the Arbeitsgemeinschaft Gynäkologische Onkologie(AGO)Study Group [J]. Eur J Cancer, 2013, 49(8): 1905-1914.
[18] Lazarou A, Fotopoulou C, Coumbos A, et al. Long-term follow-up of borderline ovarian tumors clinical outcome and prognostic factors [J]. Anticancer Res, 2014, 34(11): 6725-6730.
[19] Chevrot A, Pouget N, Bats AS, et al. Fertility and prognosis of borderline ovarian tumor after conservative management: results of the multicentric OPTIBOT study by the GINECO & TMRG group [J]. Gynecol Oncol, 2020, 157(1): 29-35.
[20] Boivin J, Bunting L, Collins JA, et al. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care [J]. Hum Reprod, 2007, 22(6): 1506-1512.
[21] Plett H, Harter P, Ataseven B, et al. Fertility-sparing surgery and reproductive-outcomes in patients with borderline ovarian tumors [J]. Gynecol Oncol, 2020, 157(2): 411-417.
[22] 张悦, 王倩男, 黄珍, 等. 保留生育功能手术对卵巢交界性肿瘤患者预后及生育结局的影响 [J]. 中华医学杂志, 2022, 102(26): 1999-2004. ZHANG Yue, WANG Qiannan, HUANG Zhen, et al. Prognosis and fertility outcomes of patients with borderline ovarian tumors after fertility-sparing surgery [J]. National Medical Journal of China, 2022, 102(26): 1999-2004.
[23] Uzan C, Muller E, Kane A, et al. Prognostic factors for recurrence after conservative treatment in a series of 119 patients with stage I serous borderline tumors of the ovary [J]. Ann Oncol, 2014, 25(1): 166-171.
[24] Koskas M, Uzan C, Gouy S, et al. Fertility determinants after conservative surgery for mucinous borderline tumours of the ovary(excluding peritoneal pseudomyxoma)[J]. Hum Reprod, 2011, 26(4): 808-814.
[25] Romagnolo C, Gadducci A, Sartori E, et al. Management of borderline ovarian tumors: results of an Italian multicenter study [J]. Gynecol Oncol, 2006, 101(2): 255-260.
[26] Ouldamer L, Bendifallah S, Naoura I, et al. Nomogram to predict live birth rate after fertility-sparing surgery for borderline ovarian tumours [J]. Hum Reprod, 2016, 31(8): 1732-1737.
[1] ZHANG Yixin, ZHAO Yuli, FENG Li. Ultrasound characteristics and preoperative CA-125 level in the differential diagnosis of 51 cases of borderline ovarian and stage I malignant tumors [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 104-109.
[2] ZHANG Ying, YANG Jiaxin, CAO Dongyan, YU Mei, SHEN Keng, HUANG Huifang, PAN Lingya, WU Ming, LANG Jinghe, YOU Yan. Prognostic factors for oncology and fertility outcomes of early stage epithelial ovarian cancer patients who accepted fertility-sparing surgery [J]. Journal of Shandong University (Health Sciences), 2018, 56(5): 13-17.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd