卵巢交界性肿瘤复发相关因素临床特点及处理原则

Recurrence of borderline ovarian tumor:the related factors,clinical characteristics and management strategy

卵巢交界性肿瘤总体复发率为11%。复发的不良因素主要包括:进展期、浸润性种植、病灶残留。保守性手术的复发率高,但大部分复发仍为交界性,且局限于卵巢内,不影响生存率。对于卵巢内复发,渴望保留生育功能的年轻患者,如没有浸润性种植并可接受长期严密随访,可再次行保守性手术。如果存在浸润性种植、卵巢外复发或进展为恶性卵巢癌,应行肿瘤细胞减灭术。目前没有证据表明术后化疗对于复发性交界性肿瘤有益。

The overall recurrence rate for borderline ovarian tumors is estimated to be 11%. Major nega- tive prognostic factors for recurrence are more ad- vanced disease, the presence of invasive implants and/or the presence of postoperative macroscopic re- sidual disease. The rate of recurrence is higher after conservative surgery. Most of these recurrences are borderline type and are found on the spared ovary with an excellent long-term survival. If a relapse in the remaining ovary occurs without invasive implants, further conservative management may be offered to patients who are young, desire fertility pres- ervation, and engage in long-term follow-up. When extraovarian recurrence, invasive implants or inva- sive disease occur, extensive cytoreductive surgery is the treatment option of choice. To date, there is no proven benefit from adjuvant chemotherapy.