卵巢交界性肿瘤9例复发后再行保留生育功能手术的临床分析

Clinical analysis of 9 cases of borderline ovarian tumor recurrence after surgery and retention of reproductive function

目的探讨卵巢交界性肿瘤复发后再次行保留生育功能手术的临床意义及可行性。方法回顾性分析2004年3月至2012年6月收治的9例再次施行保留生育功能手术的复发性卵巢交界性肿瘤患者的临床病理特征、患者生存和肿瘤复发情况以及手术后的月经、生育情况。结果 9例复发性卵巢交界性肿瘤患者的平均年龄为25.8岁,均未生育,再次手术后病理结果仍为卵巢交界性肿瘤,其中复发病灶仍局限于卵巢的7例。9例复发性卵巢交界性肿瘤患者中,再次手术后月经仍规律7例,2例患者术后出现经期延长和月经量减少。其中成功妊娠并顺利分娩4例。平均随访时间63个月,最长123个月,最短24个月,2例患者再次手术后提示再次复发,其中1例患者再次复发后行第3次手术治疗,术后病理结果仍为卵巢交界性肿瘤;另1例仅B超检查提示卵巢病变,未经手术证实。本组患者在随访期间未发生肿瘤相关性死亡。结论对于有强烈生育要求、年轻的复发性卵巢交界性肿瘤患者,再次保留生育功能手术是可行的,术后仍有较高的妊娠成功率,但仍存在复发可能,需严密随访。

Objective To analyze the clinical practicability and significance of fertility-sparing surgery for women with recurrent border-line ovarian tumors( BOT). Methods The clinical and pathological recording of 9 patients sufferring from recurrent BOT in our hospital from March 2004 to June 2012 were analyzed retrospectively. The menstruation situation,fertility function,recurrence rate and survival after second conservative surgery were collected and analyzed. Results The average onset age of these nine patients was 25. 7 years,and none of them had procreation before the second operation. The pathological diagnosis were still BOT and the recurrent sites of 7 patients were still restricted to the o-varies. 7 cases of them had normal menstruation functions and 2 cases had less menstrual volumes or longer menstrual periods. Among 6 cases de-sired for pregnancy after the second operation,4 cases of them were successful. The mean duration of follow-up was 63 months( range:24~123 months). Among all recurrent BOT,2 cases developed recurrence once more. 1 case of them were just be hinted by B ultrasounds and only one ca-ses was approved to be BOT again by a once more surgical pathology. But no disease related deaths occurred. Conclusion The second fertility-sparing surgery may be feasible for women with recurrent BOT who are young and strongly desired for preservation of fertility. The spontaneous pregnancy rate is satisfactory. However,carefully follow-up is still needed.