Outcomes of Fertility Sparing Surgery for Borderline Ovarian Tumors

Year 2024, , 52 - 58, 09.06.2024

Dilara Sarıkaya Kurt , Ayse Sinem Duru Çöteli , Ahmet Kurt , Nurettin Boran

https://doi.org/10.46969/EZH.1476817

Abstract

Aim: The aim of this study was to investigate the results of fertility-preserving and/or radical surgery, the effects of fertility-preserving surgery on fertility and the postoperative recurrence rate in patients with borderline ovarian tumors.
Material and Method: The study included 138 patients who were diagnosed with borderline ovarian tumors in the oncology clinic of a tertiary institution in Ankara. The patients’ data were analyzed retrospectively from the hospital information system. Among 138 patients, age, parity, type of surgery, number of lymph nodes removed, recurrence rates, pregnancy rates after treatment and fertility and recurrence analysis were performed. Recurrence and fertility rates were compared between those who underwent fertility preserving surgery and those who did not.
Results: The distribution of the patıents’ age groups is as follows: 21% of the patients were under the age of 30; 26.1% were between 31-40 years of age, and 21% were between 41-50 years of age. The BMI data of the patients shows that 20.3% of the patients were in normal weight, on the contrary, 44.9% were overweight (25 kg/m2 to 29.9 kg/m2). According to the pathology results of the patients, 63% (n=87) were serous, 31.9% (n=44) mucinous, 5.1% (n=7) endometrioid type borderline ovarian tumors. Spontaneous pregnancy was observed in 31% (n=18) and pregnancy as a result of assisted reproductive techniques in 5.2% (n=3) of the patients who underwent fertility preserving surgery. According to the results of the study, it is observed that there is a statistical relationship between recurrence and fertility preservation. Recurrence was observed in 2.5% (n=2) of the individuals whose fertility was not preserved while recurrence was observed in 24.1% (n=14) of individuals whose fertility was preserved. Although it was observed that recurrence increased in patients who underwent fertility preservation surgery, it allowed pregnancy to be achieved at a rate of approximately 36%.
Conclusion: Since patients with borderline ovarian tumours are younger than patients with invasive ovarian cancer, fertility-sparing surgery is becoming increasingly important.

Keywords

Epithelial ovarian cancer, recurrence, fertility, surgery

Borderline Over Tümörlerinde Fertilite Koruyucu Cerrahi Sonuçları

Abstract

Amaç: Bu çalışmanın amacı borderline over tümörüne sahip hastalarda fertilite koruyucu ve/veya radikal cerrahilerin sonuçlarını, fertilite koruyucu cerrahinin fertilite üzerine etkisini ve postoperatif nüks oranlarını araştırmaktır.
Gereç ve Yöntem: Çalışmaya Ankara’da yer alan 3. basamak bir sağlık kuruluşunun onkoloji kliniğinde borderline over tümörü tanısı alan 138 hasta dahil edildi. Hastaların verileri hastane bilgi sisteminden retrospektif olarak analiz edilmiştir. 138 hastanın yaş, parite, ameliyat tipi, çıkarılan lenf nodu sayısı, nüks oranları, tedavi sonrası gebelik oranları ve doğurganlık ve nüks analizleri yapıldı. Nüks ve fertilite oranları fertilite koruyucu cerrahi uygulananlar ve uygulanmayanlar arasında karşılaştırıldı.
Bulgular: Hastaların yaş gruplarına göre dağılımı aşağıdaki gibidir: Hastaların %21’i 30 yaşın altında; %26,1’i 31-40 yaş arasında ve %21’i 41-50 yaş arasındadır. Hastaların VKİ verileri, hastaların %20,3’ünün normal kiloda olduğunu, buna karşılık %44,9’unun aşırı kilolu (25 kg/m2 ila 29,9 kg/m2) olduğunu göstermektedir. Hastaların patoloji sonuçlarına göre %63’ü (n=87) seröz, %31,9’u (n=44) müsinöz, %5,1’i (n=7) endometrioid tip borderline over tümörüdür. Fertilite koruyucu cerrahi uygulanan hastaların %31’inde (n=18) spontan gebelik, %5,2’sinde (n=3) ise yardımcı üreme teknikleri sonucu gebelik gözlendi. Çalışma sonuçlarına göre, nüks ile fertilite koruma arasında istatistiksel bir ilişki olduğu görülmektedir. Fertilitesi korunmayan bireylerin %2,5’inde (n=2) nüks gözlenirken, fertilitesi korunan bireylerin %24,1’inde (n=14) nüks gözlenmiştir. Fertilite koruma cerrahisi uygulanan hastalarda nüksün arttığı gözlense de yaklaşık %36 oranında gebelik elde edilmesine olanak sağlamıştır.
Sonuç: Borderline over tümörlü hastalar invaziv over kanserli hastalardan daha genç olduğundan, fertilite koruyucu cerrahi giderek daha önemli hale gelmektedir.

Keywords

Epitelyal over kanseri, rekürrens, fertilite, cerrahi

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