卵巢交界性肿瘤患者保留生育功能的手术治疗进展

Fertility-sparing Surgery in Borderline Ovarian Tumor

卵巢交界性肿瘤是一类组织病理学和生物学行为介于良性、恶性之间的卵巢肿瘤。患者多年轻、有生育要求,早期多见,且总体预后好。影响卵巢交界性肿瘤患者预后的主要因素是分期、是否存在腹膜浸润性种植、术后是否存在肿瘤残留等。早期患者行保留生育功能手术是安全有效的,不影响总生存率与生存时间;而对有生育要求的晚期患者,可在全面分期手术的基础上行保留生育功能的手术;对于复发患者,保留生育功能手术仍可酌情考虑。腹腔镜手术增加复发率,但并不影响生存率,对于早期患者,腹腔镜的保守手术也是安全可行的。

Borderline ovarian tumor（BOT） is characterized by histopathologic features and biologic behaviors,which intermediate between clearly benign and frankly malignant ovarian tumors.Most patients are young and in need of fertility.The majority of BOT are diagnosed at early stage,with good prognosis.Factors that are detrimental to survival are stage of the disease,the occurrence of invasive peritoneal implants and residual tumor.Fertility-sparing surgery is safe for early stage patients with no influence in overall survival.Fertility preservation is not found to be associated with an increased risk of relapse in young patients with advanced disease,and may be reasonably considered and performed on the base of comprehensive staging surgery.Laparoscopic conservative surgery has meaningful influence on recurrence rate,but has no influence on survival rate.Laparoscopic conservative surgery can be accepted under close follow-ups.