卵巢边界肿瘤:一家三级转诊中心 37 年的经验。

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Rosie McBain, Aidan Kashyap, Milly Bishop, Estefania Vicario, Mila Volchek, Yael Naaman, Niveditha Rajadevan, Antonia Jones, Deborah Neesham, Orla McNally
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引用次数: 0

摘要

导言边界卵巢肿瘤(BOT)是一种常见的上皮性卵巢肿瘤。边界卵巢肿瘤通常在早期诊断,预后良好,许多 BOT 采用保守治疗。复发很常见。此次更新是对 1997 年进行的上一次审计的更新,也是迄今为止规模最大的 BOT 审计之一:纳入1984年至2021年在 "医院 "接受治疗的所有BOT患者。结果:共纳入 549 例患者:结果:共纳入 549 例患者。复发率为5%(n=29/549),其中1.4%(n=8/549)发生恶性转化。在复发为癌症的 8 名妇女中,有 3 人死于癌症。冰冻切片可预测92%(n = 55/60)的浆液性肿瘤(SBOT)的组织学诊断,但只能预测62%(n = 54/87)的粘液性肿瘤(MBOT)的组织学诊断。在术中阑尾显示正常的 MBOT 中,所有病例(n = 63)在组织学上都是良性的。在 SBOT 中,复发率分别为 5/23(22%)、12/52(23%)、1/29(3%)和 3%(P = 讨论):本研究描述了首次手术和保胎手术与复发和恶性转化相关的重要信息。对于所有 BOT 亚型,保留生育功能的手术会增加复发风险,而子宫切除术并不比双侧卵巢切除术更优越。在 MBOT 中,冰冻切片的作用有限,如果 MBOT 是真正的组织学诊断,那么宏观正常的阑尾不太可能是良性的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Borderline tumours of the ovary: A 37-year experience at a tertiary referral centre.

Introduction: Borderline ovarian tumours (BOT) are a common epithelial ovarian tumours. Typically diagnosed at an early stage with a good prognosis, many BOT are treated conservatively. Recurrence is common. This update to our last audit in 1997 represents one of the largest audits of BOT to date.

Materials and methods: All patients with BOT managed at 'the hospital' from 1984 to 2021 were included. Expert pathology review was available.

Results: There were 549 cases included. The recurrence rate was 5% (n = 29/549) with 1.4% (n = 8/549) undergoing malignant transformation. Three of the eight women who recurred as cancer died from their disease. Frozen section was predictive of histologic diagnosis in 92% (n = 55/60) of serous tumours (SBOT), but only 62% (n = 54/87) of mucinous tumours (MBOT). In MBOT where the appendix appeared normal intra-operatively, it was histologically benign in all cases (n = 63). In SBOT, the recurrence rate was 5/23 (22%), 12/52 (23%), 1/29 (3%) and 3% (P = <0.01) for unilateral cystectomy, unilateral oophorectomy ± cystectomy, bilateral oophorectomy, and bilateral oophorectomy with hysterectomy, respectively, as index procedure. In MBOT this correlated to 2/20 (10%), 3/93 (3%), 0 and 1/58 (2%), respectively.

Discussion: This study describes important information correlating first surgical procedure and fertility-sparing surgery to recurrence and malignant transformation. For all BOT subtypes, fertility-preserving surgery increased the risk of recurrence and hysterectomy was not superior to removal of both ovaries. In MBOT, frozen section is of limited utility and the macroscopically normal appendix is very unlikely to be anything but benign, if MBOT is the true histologic diagnosis.

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来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
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