Effects of Fertility-Sparing Surgery on Prognosis and Fertility of Patients With Ovarian Borderline Tumors
Objective To compare the safety and efficacy of fertility-sparing surgery in patients with o-varian borderline tumors(BOT).Methods A total of 121 BOT patients undergoing fertility-sparing surgery be-tween January 2010 and October 2022 were retrospectively analyzed.The univariate analysis,multivariate analy-sis,and survival curves were employed to evaluate the clinicopathological and surgical variables and fertility.Results The 121 BOT patients included in this study showed the 5-year recurrence-free survival(RFS)rate of 65.8％and the recurrence rate of 30.5％.A total of 53 patients attempted to conceive and 40(33.06％)of the patients achieved successful pregnancy.Different methods of fertility-sparing surgery did not affect the tumor re-currence rate,RFS,or pregnancy rate.The multivariate analysis indicated that the International Federation of Gynecology and Obstetrics(FIGO)stage ≥ Ⅱ was an independent risk factor affecting both postoperative recur-rence and RFS(P=0.011,OR=6.504,95％CI=1.534-27.58;P=0.033,HR=2.589,95％CI=1.082-6.194)in BOT patients.Tissue type(mucinous)was negatively correlated with the risk of recurrence af-ter fertility-sparing surgery(P=0.011,OR=0.270,95％CI=0.099-0.739).The two unilateral surgical methods showed differences in the amount of intraoperative bleeding(P=0.010),postoperative hospital stay(P=0.001),duration of antibiotic use(P=0.002),and tumor rupture rate(P=0.030),which were not signifi-cantly different between the two bilateral surgical methods.Conclusions For young patients with fertility require-ments,fertility-sparing surgery is safe and effective.After a comprehensive assessment of clinicopathological fac-tors,unilateral cystectomy and bilateral cystectomy may be recommended as the preferred choice of treatment.For the patients with advanced FIGO stages who strongly prefer fertility sparing,fertility-sparing surgery can be per-formed with fully informed consent,and these patients should attempt to achieve pregnancy as soon as possible after the surgery.
万方数据
维普
