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目的探讨卵巢交界性肿瘤(borderline ovarian tumors,BOTs)的治疗。方法对郑州市第三人民医院1990～2010年收治的79例BOTs患者进行回顾性分析,探讨其治疗经过和预后。结果 79例BOTs的病理类型:浆液性40例(50.6%),黏液性26例(32.9%),混合性9例(11.4%),其他类型4例(5.1%)。手术-病理分期:Ⅰa期56例(70.9%),Ⅰb期4例(5.1%),Ⅰc期14例(17.7%),Ⅱ期3例(3.8%),Ⅲ期2例(2.5%)。所有患者均行手术治疗,40例(50.6%)行保留生育功能的保守性手术,其中行囊肿剔除术11例。79例中18例行淋巴结切除术,15例行术后辅助化疗,但早期患者的预后与淋巴结切除及辅助化疗与否关系不大。68例术后随访4～122月,平均72个月,1例Ⅲ期患者术后复发,2年内死于肠梗阻;1例自然死亡。结论对Ⅰ期有生育要求的患者可行保留生育功能手术,Ⅰa期患者行囊肿剔除手术是相对安全的;早期患者不必行淋巴结清扫。对有高危因素的患者,术后短期内适当给予化疗,防止复发是必要的。
Objective To investigate the treatment of borderline ovarian tumors (BOTs). Methods A retrospective analysis of 79 cases of BOTs admitted to the Third People ’s Hospital of Zhengzhou from 1990 to 2010 was conducted to discuss the treatment course and prognosis. Results The pathological types of 79 BOTs were serous in 40 cases (50.6%), mucinous in 26 cases (32.9%), mixed in 9 cases (11.4%) and other types in 4 cases (5.1%). Surgical - pathological staging was 56 cases (70.9%) in stage Ⅰa, 4 cases (5.1%) in stage Ⅰb, 14 cases (17.7%) in stage Ⅰc, 3 cases (3.8%) in stage Ⅱ and 2 cases (2.5%) in stage Ⅲ. All patients underwent surgical treatment. Forty patients (50.6%) underwent conservative surgery with reproductive function, of which 11 were cyst excision. Of the 79 cases, 18 were treated with lymphadenectomy and 15 were treated with postoperative adjuvant chemotherapy. However, the prognosis of early patients was not related to lymph node dissection and adjuvant chemotherapy. 68 patients were followed up for 4 ~ 122 months, an average of 72 months, 1 case of stage Ⅲ patients relapsed after surgery, died of intestinal obstruction within 2 years; 1 case of natural death. Conclusion It is practicable to retain fertility surgery in patients with stage Ⅰ fertility requirements. It is relatively safe to perform cyst excision in stage Ⅰa patients. In early stage, it is not necessary to perform lymph node dissection. For patients with risk factors, appropriate short-term postoperative chemotherapy to prevent recurrence is necessary.