在更年期的边缘性卵巢瘤中切除子宫还是不切除子宫?
Diego Raimondo1, Antonio Raffone2, Manuela Maletta3
1Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Gynecologic oncology
|April 10, 2025
概括
在有边缘性卵巢瘤 (BOT) 的绝经后妇女的子宫切除术显著降低了复发风险. 虽然它不会影响整体或疾病特异性存活率,但它应该被整合到BOT的手术分期中.
科学领域:
- 妇科瘤学 妇科瘤学
- 手术瘤学手术瘤学
- 生殖医学 生殖医学
背景情况:
- 绝经后妇女边缘性卵巢瘤 (BOT) 的最佳手术管理仍然不确定.
- 在这种患者群体中切除子宫的特殊作用需要进一步研究.
研究的目的:
- 为了评估子宫切除术对被诊断为边缘性卵巢瘤的绝经后妇女的生存结果的影响.
- 为了确定宫内切除术是否会影响该人口群体的疾病复发率和生存率.
主要方法:
- 进行了一项全国性的,多中心的,观察性,回顾性队列研究.
- 分析了在2005年至2017年期间接受初级手术的经过绝经后患者.
- 患者被分为分层切除子宫和非切除子宫组,以比较无疾病生存率 (DFS),总生存率 (OS) 和疾病特异性生存率 (DSS).
主要成果:
- 与没有切除子宫的组相比,切除子宫的复发率明显较低 (2.7%vs8.3%).
- 切除子宫组的5年无疾病生存率更高 (98.5%对92.4%).
- 多变量分析确定了切除子宫作为独立的预防复发的保护因素 (HR:0.253).
结论:
- 经过绝经后妇女的子宫切除术与BOT相关,降低了疾病复发的风险.
- 该程序没有显示出对任何原因死亡风险或BOT特定死亡率的显著影响.
- 建议将子宫切除术常规整合到绝经后妇女的BOT手术分期中.
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