交界性卵巢肿瘤再分期手术11例临床分析

An Analysis of Restaging Surgery for 11 Cases of Borderline Ovarian Tumor

目的:探讨交界性卵巢肿瘤再分期手术的临床价值。方法:2006年1月至2010年12月在外院初次手术未全面分期而在我院接受再分期手术的交界性卵巢肿瘤患者共11例,平均年龄34.1岁,其中ⅠA期9例,ⅠB期2例;组织学类型:浆液性交界性肿瘤7例,黏液性交界性肿瘤3例,子宫内膜样交界性肿瘤1例。结果:经过再分期手术,4例患者分期提高,包括1例黏液性交界性卵巢肿瘤,1例子宫内膜样交界性卵巢肿瘤和2例浆液性交界性卵巢肿瘤。初次手术残留肿瘤的部位为对侧卵巢1例,腹腔冲洗液中3例发现肿瘤细胞(其中1例初次手术为腹腔镜术中肿瘤破裂)。再分期术后随访至今,共随访18～70个月,平均随访时间42.6个月,分期未改变的7例患者和分期提高的4例患者均无复发。结论:对于交界性卵巢肿瘤,是否再分期手术需结合患者初次手术探查的彻底性、肿瘤的组织学亚型和患者的观点综合考虑,再分期手术对于浆液性肿瘤患者可能有益。

Objective：To analyze the value of restaging surgery for borderline ovarian tumor. Methods： From Jan. 2006 to Dec. 2010,11 cases were surgically restaged at our institution, after having initial surgery elsewhere. Mean age was 34. 1 years old. Initial FIGO staging was IA,9 cases;IB,2 cases. Histological sub- type was as follows： serous tumor,7 cases; mucinous tumor,3 and endometroid tumor, 1. Results ：4 cases had disease upstaged by restaging surgery,which included 1 case of mucinous tumor,1 case of endometroid tumor and 2 cases of serous. 1 case had residual tumor in opposite ovary and 3 cases were found positive peritoneal lavage cytology. The mean follow-up time was 42.6 months （18-70 months） ,and there was no re- currence both in 7 patients who were not up-staged and 4 patients who were up-staged. Conclusions： For patients with BOT who were not received comprehensive staging surgery at initial operation, restaging surgery should be balanced, considering the thoroughness of initial surgery, subtype of the tumor and also the pa- tients＇ opinion. Patients with serious BOT may benefit from restaging surgery.