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Abstract：
OBJECTIVE: To describe the characteristics of children and adolescents with borderline ovarian tumors (BOTs) and evaluate the efficacy and safety of fertility-sparing surgery (FSS) in these patients.
METHODS: Patients with BOTs younger than 20 years who underwent FSS were included in this study.
RESULTS: A total of 34 patients were included, with a median patient age of 17 (range, 3-19) years; 97.1% (33/34) of cases occurred after menarche. Of the patients, 82.4% had mucinous borderline tumors (MBOTs), 14.7% had serous borderline tumors (SBOTs), and 2.9% had seromucinous borderline tumor (SMBOT). The median tumor size was 20.4 (range, 8-40)cm. All patients were at International Federation of Gynecology and Obstetrics stage I and all underwent FSS: cystectomy (unilateral ovarian cystectomy, UC, 14/34, 41.2% and bilateral ovarian cystectomy, BC, 1/34, 2.9%), unilateral salpingo-oophorectomy (USO; 18/34; 52.9%), or USO + contralateral ovarian cystectomy (1/34; 2.9%). The median follow-up time was 65 (range, 10-148) months. Recurrence was experienced by 10 of the 34 patients (29.4%). One patient with SBOT experienced progression to low-grade serous carcinoma after the third relapse. Two patients had a total of four pregnancies, resulting in three live births. The recurrence rate of UC was significantly higher in MBOTs than in USO (p = 0.005). The 5-year disease-free survival rate was 67.1%, and the 5-year overall survival rate was 100%.
CONCLUSIONS: Fertility-sparing surgery is feasible and safe for children and adolescents with BOTs. For patients with MBOTs, USO is recommended to lower the risk of recurrence.
METHODS: Patients with BOTs younger than 20 years who underwent FSS were included in this study.
RESULTS: A total of 34 patients were included, with a median patient age of 17 (range, 3-19) years; 97.1% (33/34) of cases occurred after menarche. Of the patients, 82.4% had mucinous borderline tumors (MBOTs), 14.7% had serous borderline tumors (SBOTs), and 2.9% had seromucinous borderline tumor (SMBOT). The median tumor size was 20.4 (range, 8-40)cm. All patients were at International Federation of Gynecology and Obstetrics stage I and all underwent FSS: cystectomy (unilateral ovarian cystectomy, UC, 14/34, 41.2% and bilateral ovarian cystectomy, BC, 1/34, 2.9%), unilateral salpingo-oophorectomy (USO; 18/34; 52.9%), or USO + contralateral ovarian cystectomy (1/34; 2.9%). The median follow-up time was 65 (range, 10-148) months. Recurrence was experienced by 10 of the 34 patients (29.4%). One patient with SBOT experienced progression to low-grade serous carcinoma after the third relapse. Two patients had a total of four pregnancies, resulting in three live births. The recurrence rate of UC was significantly higher in MBOTs than in USO (p = 0.005). The 5-year disease-free survival rate was 67.1%, and the 5-year overall survival rate was 100%.
CONCLUSIONS: Fertility-sparing surgery is feasible and safe for children and adolescents with BOTs. For patients with MBOTs, USO is recommended to lower the risk of recurrence.
摘要：
目的：描述儿童和青少年卵巢交界性肿瘤（BOT）的特征，并评估保留生育功能手术（FSS）在这些患者中的疗效和安全性。
方法：这项研究纳入了20岁以下接受FSS的BOT患者。
结果：共纳入34例患者，患者年龄中位数为17岁(范围，3-19）年；97.1％（33/34）的病例发生在初潮后。在患者中，82.4%有黏液性交界性肿瘤(MBOTs),14.7%有浆液性交界性肿瘤(SBOTs),2.9%患有浆膜粘质交界性肿瘤(SMBOT)。中位肿瘤大小为20.4（范围，8-40）厘米。所有患者均为国际妇产科联合会I期，均接受FSS：膀胱切除术（单侧卵巢囊肿切除术，UC,14/34，41.2%，双侧卵巢囊肿切除术，BC,1/34，2.9%），单侧输卵管卵巢切除术（USO;18/34;52.9％），或USO+对侧卵巢囊肿切除术(1/34;2.9%)。中位随访时间为65（范围，10-148）个月。34例患者中有10例（29.4%）出现复发。一名SBOT患者在第三次复发后进展为低度浆液性癌。两名患者总共怀孕了四次，导致三个活产。MBOTs的UC复发率明显高于USO（p=0.005）。5年无病生存率为67.1%,5年总生存率为100%。
结论：保留生育功能的手术对于患有BOT的儿童和青少年是可行且安全的。对于MBOTs患者，建议使用USO降低复发风险。
方法：这项研究纳入了20岁以下接受FSS的BOT患者。
结果：共纳入34例患者，患者年龄中位数为17岁(范围，3-19）年；97.1％（33/34）的病例发生在初潮后。在患者中，82.4%有黏液性交界性肿瘤(MBOTs),14.7%有浆液性交界性肿瘤(SBOTs),2.9%患有浆膜粘质交界性肿瘤(SMBOT)。中位肿瘤大小为20.4（范围，8-40）厘米。所有患者均为国际妇产科联合会I期，均接受FSS：膀胱切除术（单侧卵巢囊肿切除术，UC,14/34，41.2%，双侧卵巢囊肿切除术，BC,1/34，2.9%），单侧输卵管卵巢切除术（USO;18/34;52.9％），或USO+对侧卵巢囊肿切除术(1/34;2.9%)。中位随访时间为65（范围，10-148）个月。34例患者中有10例（29.4%）出现复发。一名SBOT患者在第三次复发后进展为低度浆液性癌。两名患者总共怀孕了四次，导致三个活产。MBOTs的UC复发率明显高于USO（p=0.005）。5年无病生存率为67.1%,5年总生存率为100%。
结论：保留生育功能的手术对于患有BOT的儿童和青少年是可行且安全的。对于MBOTs患者，建议使用USO降低复发风险。
